老年人医院跌倒的时间预防：一项混合方法研究的方案

Chronoprevention in hospital falls of older people: protocol for a mixed-method study.

作者信息

López-Soto Pablo Jesús, López-Carrasco Juan de la Cruz, Fabbian Fabio, Miñarro-Del Moral Rosa María, Segura-Ruiz Rocío, Hidalgo-Lopezosa Pedro, Manfredini Roberto, Rodríguez-Borrego María Aurora

机构信息

Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004, Córdoba, Spain.

Área de Enfermería, Faculty of Medicine and Nursing, University of Cordoba, Avda. Menéndez Pidal s/n, 14071, Córdoba, Spain.

出版信息

BMC Nurs. 2021 Jun 6;20(1):88. doi: 10.1186/s12912-021-00618-y.

DOI:10.1186/s12912-021-00618-y

PMID:34092223

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8183051/

Abstract

BACKGROUND

Accidental falls in hospitals are serious events concerning the safety of the patients. Recent studies demonstrated that the time of falls is a key factor to be considered in prevention. It has been shown that the time of day, the day of the week and the month of the year impact on the occurrence of falls. The aim of the study is to determine the effect of the application of a programme of preventive measures based on the temporal patterns of the risk factors on the hospital fall occurrence.

METHODS

A mixed-method research design. The following three phases will be carried out: 1) Longitudinal prospective study in two parts: (a) audits and seminars of healthcare professionals focused on an effective and efficient hospital falls register. Multi-Component and Single Cosinor analyses will be performed to obtain the temporal patterns of hospital falls and their related variables and (b) implementation of a based-temporal patterns, multidimensional prevention programme. 2) Retrospective study of falls registered in institutional databases. 3) Qualitative study based on focus groups (physicians, nurses and nursing assistants). The study protocol was approved in 2018.

DISCUSSION

With regard to the safety of patients, hospital falls are serious events. Recent studies have demonstrated that the time of falls is a key factor to be considered in prevention. It has been shown that the time of day, the day of the week and the month of the year impact on the occurrence of falls. It is imperative to study temporal patterns of hospital falls to effectively and comprehensively define the aetiology of falls and, therefore, design preventive strategies. A reduction of the number of in-hospital falls and related injuries is expected, as well as an improvement in the quality of life of patients. Considering temporal patterns and levels of mood and sleep of healthcare professionals will achieve an improvement in patient safety.

TRIAL REGISTRATION

Retrospectively registered in ClinicalTrials.gov ID: NCT04367298.

摘要

背景

医院内的意外跌倒属于关乎患者安全的严重事件。近期研究表明，跌倒时间是预防工作中需考虑的关键因素。研究显示，一天中的时段、一周中的日期以及一年中的月份都会对跌倒的发生产生影响。本研究的目的是确定基于风险因素的时间模式应用预防措施方案对医院跌倒发生率的影响。

方法

采用混合方法研究设计。将开展以下三个阶段的工作：1）分为两部分的纵向前瞻性研究：（a）针对有效且高效的医院跌倒登记册对医疗保健专业人员进行审核和举办研讨会。将进行多因素和单余弦分析，以获取医院跌倒及其相关变量的时间模式，以及（b）实施基于时间模式的多维预防方案。2）对机构数据库中登记的跌倒事件进行回顾性研究。3）基于焦点小组（医生、护士和护理助理）的定性研究。该研究方案于2018年获得批准。

讨论

就患者安全而言，医院跌倒属于严重事件。近期研究表明，跌倒时间是预防工作中需考虑的关键因素。研究显示，一天中的时段、一周中的日期以及一年中的月份都会对跌倒的发生产生影响。必须研究医院跌倒的时间模式，以有效且全面地确定跌倒的病因，从而设计预防策略。预计可减少院内跌倒及相关伤害的数量，并改善患者的生活质量。考虑医疗保健专业人员的时间模式以及情绪和睡眠水平将实现患者安全的改善。