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住院患者睡在带窗病床比睡在非带窗病床的院内跌倒发生率更低。

Lower Incidence of In-Hospital Falls in Patients Hospitalized in Window Beds Than Nonwindow Beds.

机构信息

Department of Nursing, Tenri Health Care University, Nara, Japan.

Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.

出版信息

J Am Med Dir Assoc. 2020 Apr;21(4):476-480. doi: 10.1016/j.jamda.2019.07.006. Epub 2019 Aug 22.

Abstract

OBJECTIVES

Comparing the incidence rate of in-hospital falls between patients hospitalized in window beds and nonwindow beds.

DESIGN

Retrospective cohort study.

SETTING

A general hospital in Mie, Japan.

PARTICIPANTS

A total of 2767 patients (mean age, 68.4 years) hospitalized in four-bedded rooms between January 2014 and December 2016.

MEASURES

We identified patients' bed status (window/nonwindow) and the incidence of in-hospital falls using data on medical records and incidence reports, respectively.

RESULTS

During an observation period of 25,450 person-days, 57 patients had in-hospital falls (incidence rate, 2.24/1000 person-days). Incidence rate for in-hospital falls was significantly lower in the window-bed group (n = 1273) than in the nonwindow-bed group (n = 1494) [incidence rate ratio (IRR) 0.49, 95% confidence interval (CI), 0.29, 0.84]. In the multivariable analysis adjusted for age, gender, BMI, smoking and drinking habit, surgical operation during hospitalization, and independence in daily living, the window-bed group exhibited significantly lower incidence rate for in-hospital falls than the nonwindow-bed group (IRR 0.54, 95% CI 0.32, 0.93). Sensitivity analysis excluding patients aged <60 years suggested a consistent result: incidence rate for in-hospital falls was significantly lower in the window-bed group (n = 1123) than in the nonwindow-bed group (n = 925) (IRR 0.55, 95% CI 0.31, 0.95).

CONCLUSIONS AND IMPLICATIONS

The incidence rate of in-hospital falls was significantly lower among patients hospitalized in window beds than nonwindow beds. Hospitalization in window beds might be a novel, simple preventive option for in-hospital falls. Further large-scale, prospective, multicenter research is required.

摘要

目的

比较住在窗床和非窗床的住院患者的院内跌倒发生率。

设计

回顾性队列研究。

地点

日本三重县的一家综合医院。

参与者

2014 年 1 月至 2016 年 12 月期间,在四人间病房住院的 2767 名患者(平均年龄 68.4 岁)。

措施

我们分别使用病历数据和事件报告来确定患者的床位状态(窗床/非窗床)和院内跌倒的发生率。

结果

在 25450 人天的观察期内,共有 57 名患者发生院内跌倒(发生率为 2.24/1000 人天)。窗床组(n=1273)的院内跌倒发生率明显低于非窗床组(n=1494)[发生率比(IRR)0.49,95%置信区间(CI)0.29,0.84]。在校正年龄、性别、BMI、吸烟和饮酒习惯、住院期间手术以及日常生活自理能力后,窗床组的院内跌倒发生率明显低于非窗床组(IRR 0.54,95%CI 0.32,0.93)。排除年龄<60 岁的患者进行敏感性分析后,结果一致:窗床组(n=1123)的院内跌倒发生率明显低于非窗床组(n=925)(IRR 0.55,95%CI 0.31,0.95)。

结论和意义

住在窗床的住院患者的院内跌倒发生率明显低于住在非窗床的患者。住院期间使用窗床可能是预防院内跌倒的一种新的简单方法。需要进一步开展大规模、前瞻性、多中心研究。

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