Suh Minhee, Cho Insook
Department of Nursing, Inha University, Incheon, South Korea.
Jpn J Nurs Sci. 2021 Apr;18(2):e12403. doi: 10.1111/jjns.12403. Epub 2021 Jan 14.
This study was carried out to analyze nursing care provided to patients on high and low fall-risk days and to evaluate the effectiveness of nursing care in terms of preventing falls.
A retrospective review of medical records was conducted for patients admitted to a tertiary hospital in Korea. General and clinical information, fall occurrences, Hendrich II Fall Risk Model (HFRM II) fall-risk assessment scores, nursing care related to fall prevention, and medications administered were extracted.
Data from 43,267 days of records for 11,718 patients were analyzed. Nursing assessment, intervention, and administration of medication were provided more frequently on high fall-risk days than on low fall-risk days. Analysis performed on the entire cohort days showed fall occurrence was significantly associated with infrequent mobility assessment and greater usage of anti-anxiety agents. On high fall-risk days, fall occurrence was related to less restraint assessment and greater usage of vessel dilatators.
The implementation of risk-targeted interventions for fall prevention based on fall-risk assessment is needed. For general fall prevention, assessment of patients' mobility should be strengthened. For high fall-risk patients, it may be more effective for nurses to focus on assessing restraints, evaluating medication records, and withdrawing medications related to falls.
本研究旨在分析在高跌倒风险日和低跌倒风险日为患者提供的护理，并评估预防跌倒护理的有效性。
对韩国一家三级医院收治的患者病历进行回顾性分析。提取患者的一般和临床信息、跌倒发生情况、亨德里克二世跌倒风险模型（HFRM II）跌倒风险评估分数、与预防跌倒相关的护理措施以及所使用的药物。
分析了11718例患者43267天的记录数据。在高跌倒风险日比在低跌倒风险日更频繁地进行护理评估、干预和给药。对整个队列日的分析表明，跌倒发生与不频繁的活动能力评估以及更多使用抗焦虑药物显著相关。在高跌倒风险日，跌倒发生与较少的约束评估以及更多使用血管扩张剂有关。
需要基于跌倒风险评估实施针对性的跌倒预防干预措施。对于一般的跌倒预防，应加强对患者活动能力的评估。对于高跌倒风险患者，护士关注约束评估、评估用药记录以及停用与跌倒相关的药物可能更有效。
