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导致即时跌倒检测失败的风险因素:一项使用零膨胀负二项回归的研究。

Risk Factors Preventing Immediate Fall Detection: A Study Using Zero-Inflated Negative Binomial Regression.

机构信息

College of Nursing, Kangwon National University, Kangwon, Republic of Korea.

Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.

出版信息

Asian Nurs Res (Korean Soc Nurs Sci). 2021 Oct;15(4):272-277. doi: 10.1016/j.anr.2021.09.001. Epub 2021 Sep 17.

Abstract

PURPOSE

Falls are the most common accidents in healthcare facilities, and timely intervention can have a positive effect on the hazards and trauma experienced by patients after a fall. This study determined the factors affecting the time taken to detect a fall.

METHODS

A total of 3,470 cases of falls reported through the Korea Patient Safety Reporting and Learning System were included in the analysis. A zero-inflated negative binomial regression method was used for this retrospective secondary data analysis study.

RESULTS

There were 537 patients whose falls were not detected immediately; the count model was used to predict risk factors that delayed fall detection. Women aged 60-69 years-compared to those below 60 years and an evening nursing shift, compared to a day shift-were identified as significant factors. The fall detection time of about 2,933 patients was zero; therefore, the logit model was applied to predict a patient's possibility of belonging to the group whose fall was detected immediately. Comparisons of tertiary hospitals with general hospitals and hospitals, of the evening shift with the day shift, and of the day shift with the night shift indicated significant influencing factors.

CONCLUSIONS

These findings can assist nurses in recognizing patient and hospital characteristics related to delayed fall detection. Strategies to improve patient safety in healthcare facilities that focus on patient characteristics such as age can be recommended. Furthermore, nurse staffing requires improvement to detect fall incidents immediately.

摘要

目的

跌倒在医疗机构中最为常见,及时干预可以对患者跌倒后所经历的危害和创伤产生积极影响。本研究旨在确定影响跌倒检测时间的因素。

方法

本回顾性二次数据分析研究共纳入通过韩国患者安全报告和学习系统报告的 3470 例跌倒事件。采用零膨胀负二项回归方法进行分析。

结果

有 537 例患者的跌倒未被及时检测到;使用计数模型预测延迟跌倒检测的风险因素。与 60 岁以下的患者相比,60-69 岁的女性和夜间护理班次更易导致跌倒未被及时检测到。约有 2933 例患者的跌倒检测时间为零;因此,应用逻辑模型预测患者属于跌倒立即被检测到的可能性。与综合医院和医院相比,与普通医院相比,与日间班次相比,与夜间班次相比,具有显著影响的因素。

结论

这些发现可以帮助护士识别与延迟跌倒检测相关的患者和医院特征。可以推荐关注患者年龄等特征的提高医疗机构中患者安全性的策略。此外,需要改善护士人力配置,以便能够立即检测到跌倒事件。

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