Aurora Health, Milwaukee, Wisconsin.
J Nurs Care Qual. 2023;38(3):243-250. doi: 10.1097/NCQ.0000000000000690. Epub 2023 Jan 18.
Falls are the leading cause of injury-related death and disability in community-dwelling older adults.
Evidence-based fall prevention activities in primary care, including nurse-facilitated wellness visits, have been limited. Barriers including patient engagement and adherence exist.
A quality improvement project integrating components of the Centers for Disease Control and Prevention's Stopping Elder Accidents, Deaths & Injury (STEADI) was introduced by registered nurses during older adult annual wellness visits.
Nurses assessed risk and implemented patient-centered fall prevention plans including follow-up.
A total of 522 patients were screened, with 21% (n = 111) having increased fall risk. Of these, 78% (n = 87) engaged in home safety, gait, strength, and balance assessments and the majority (n = 83; 95%) participated in fall prevention plans of care. At 2-week follow-up, patients' self-reported adherence was 74% for gait/strength/balance and 67% for home safety.
An expanded primary care team model shows promise for promoting fall prevention behaviors.
跌倒导致社区居住的老年人受伤相关死亡和残疾的首要原因。
包括护士主导的健康访视在内的基于循证的初级保健中的跌倒预防活动一直受到限制。存在患者参与和依从性等障碍。
注册护士在老年人年度健康访视期间引入了整合疾病控制与预防中心预防老年人意外伤害、死亡和伤害（STEADI）项目的部分内容。
护士评估风险并实施以患者为中心的跌倒预防计划，包括随访。
共对 522 名患者进行了筛查，21%（n=111）的患者跌倒风险增加。其中，78%（n=87）参与了居家安全、步态、力量和平衡评估，大多数（n=83；95%）参与了跌倒预防护理计划。在 2 周随访时，患者自我报告的步态/力量/平衡依从率为 74%，居家安全的依从率为 67%。
扩大初级保健团队模式有望促进跌倒预防行为。
