Morse 跌倒评估量表在住院患者跌倒预防护理中的成本效益分析。
Cost-effectiveness of Morse Fall Scale assessment in fall prevention care in hospitalized patients.
机构信息
Department of Nursing, Third Xiangya Hospital, Central South University, Changsha 410013.
Xiangya School of Public Health, Central South University, Changsha 410078, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 May 28;46(5):529-535. doi: 10.11817/j.issn.1672-7347.2021.200332.
OBJECTIVES
To analyze the cost-effectiveness of the Morse Fall Scale by clinical big data for nurses in the prevention of falls in hospitalized patients.
METHODS
A total of 59 358 hospitalized patients, who came from the Third Xiangya Hospital of Central South University in 1 year before nurses were trained by the Morse Fall Scale, served as a control, including 26 862 males and 32 496 females. While the 66 203 hospitalized patients served as an observation group in 1 year after nurses were trained by the Morse Fall Scale, including 29 881 males and 36 322 females. The time spent by clinical nurses in the fall-risk assessment and the fall number were recorded in the 2 groups, and the relationship was analyzed between the Morse Fall Scale assessment and the clinical ending along with the labor cost of nursing. The cost-effectiveness was analyzed. In addition, the incidence of fall in the observation group was compared between the falling high-risk patients and the non-high-risk patients.
RESULTS
The Morse Fall Scale showed that the incidences of fall in the observation group and the control group were 3.39/100 000 and 3.82/100 000,respectively, there was no significant difference between the 2 groups (=0.807, >0.05); the injury rates of falls of Grade 2 and above in the observation group and the control group were 27.30% and 20.00%, respectively, with no significant difference (χ=0.345, >0.05); but the labor cost was increased by 130 641.82 Chinses Yuan, and the incremental cost-effectiveness ratio was 43 547.27. However, the incidence of fall was significant higher in the falling high-risk patients by the assessment of the Morse Fall Scale than that in the non-high-risk patients (=2.941, <0.05).
CONCLUSIONS
The evaluation of the Morse Fall Scale has a certain effect, but it is limited in the prevention of falls in adult hospitalized patients, and the cost-effectiveness analysis is not good. It is recommended to implement the intervention measures for high-risk patients after the assessment, which may improve the management level and efficiency of fall prevention.
目的
通过临床大数据分析 Morse 跌倒量表在预防住院患者跌倒方面的成本效益。
方法
选取中南大学湘雅三医院 1 年前接受 Morse 跌倒量表培训的护士预防跌倒的 59358 例住院患者为对照组，其中男 26862 例，女 32496 例；1 年后接受 Morse 跌倒量表培训的护士预防跌倒的 66203 例住院患者为观察组，其中男 29881 例，女 36322 例。记录两组临床护士在跌倒风险评估和跌倒次数上花费的时间，并分析 Morse 跌倒量表评估与临床结局的关系，以及护理劳动力成本。进行成本效益分析。此外，比较观察组中跌倒高风险患者和非高风险患者的跌倒发生率。
结果
Morse 跌倒量表显示观察组和对照组的跌倒发生率分别为 3.39/100000 和 3.82/100000，两组间差异无统计学意义（=0.807，>0.05）；观察组和对照组跌倒损伤程度为 2 级及以上的发生率分别为 27.30%和 20.00%，差异无统计学意义（χ=0.345，>0.05）；但劳动力成本增加了 130641.82 元，增量成本效益比为 43547.27。然而，通过 Morse 跌倒量表评估，跌倒高风险患者的跌倒发生率明显高于非高风险患者（=2.941，<0.05）。
结论
Morse 跌倒量表的评估具有一定的效果，但在预防成人住院患者跌倒方面效果有限，成本效益分析不佳。建议在评估后对高风险患者实施干预措施，这可能会提高跌倒预防的管理水平和效率。
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