de Jong Lex D, Weselman Tammy, Kitchen Su, Hill Anne-Marie
School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
J Eval Clin Pract. 2020 Feb;26(1):42-49. doi: 10.1111/jep.13114. Epub 2019 Feb 20.
RATIONALE, AIMS, AND OBJECTIVES: Patient sitters provide one-to-one care for hospital patients at high risk of falls. The study aimed to explore patient sitters' task readiness to assist in fall prevention on hospital wards.
We conducted a cross-sectional survey. Respondents were patient sitters working in five hospitals providing medical, surgical, and aged care. The survey was developed using a theory of health behaviour change and used closed and open-ended items. Qualitative data were analysed using deductive content analysis.
Participants (n = 90) identified that patient factors, such as confusion, were the most frequent cause of falls (n = 338, 74%); however, the most frequent strategies identified to prevent falls were focused on the environment (n = 164, 63%). The most frequent barrier participants identified to preventing falls (n = 124, 67%) also pertained to patients, including aggressive patient behaviours. In contrast, staff factors, such as handovers being adequate, were identified as the main enabler for sitters being able to complete their tasks effectively (n = 60, 81%). Participants strongly suggested (71%) that further, preferably practical, training would be helpful, even though 84% reported receiving prior fall prevention training. Nearly all participants (98%) were motivated to prevent their patients from falling.
There is a gap between what patient sitters report as the cause of falls (patient factors) and what was suggested to prevent falls (environment factors). Education and practical training addressing challenging patient behaviours may improve sitters' task readiness to assist in preventing falls on wards. Improving communication and cooperation between patient sitters and nursing staff is also important.
原理、目的和目标:患者陪护人员为有高跌倒风险的住院患者提供一对一护理。本研究旨在探讨患者陪护人员在协助医院病房预防跌倒方面的任务准备情况。
我们开展了一项横断面调查。受访者为在五家提供医疗、外科和老年护理服务的医院工作的患者陪护人员。该调查基于健康行为改变理论编制,采用了封闭式和开放式问题。定性数据采用演绎式内容分析法进行分析。
参与者(n = 90)指出,诸如意识混乱等患者因素是跌倒的最常见原因(n = 338,74%);然而,所确定的预防跌倒的最常见策略集中在环境方面(n = 164,63%)。参与者确定的预防跌倒的最常见障碍(n = 124,67%)也与患者有关,包括患者的攻击性行为。相比之下,诸如交接班充分等 staff 因素被确定为陪护人员能够有效完成任务的主要促成因素(n = 60,81%)。参与者强烈建议(71%)进行进一步的培训,最好是实践培训,尽管84%的人报告之前接受过预防跌倒培训。几乎所有参与者(98%)都有动力防止他们的患者跌倒。
患者陪护人员报告的跌倒原因(患者因素)与所建议的预防跌倒措施(环境因素)之间存在差距。针对具有挑战性的患者行为开展教育和实践培训可能会提高陪护人员在协助病房预防跌倒方面的任务准备情况。改善患者陪护人员与护理人员之间的沟通与合作也很重要。