使用自回归积分滑动平均模型分析多因素跌倒预防计划。
Analyzing a Multifactorial Fall Prevention Program Using ARIMA Models.
作者信息
Mulkey David C, Fedo Marc A, Loresto Figaro L
机构信息
Nursing Education and Research Department, Denver Health and Hospital Authority, Denver, Colorado (Drs Mulkey and Loresto); Boulder Community Health, Boulder, Colorado (Mr Fedo); Nursing Research, Innovation, and Professional Practice Department, Children's Hospital Colorado, Aurora (Dr Loresto); and College of Nursing, University of Colorado, Aurora (Dr Loresto).
出版信息
J Nurs Care Qual. 2023;38(2):177-184. doi: 10.1097/NCQ.0000000000000681. Epub 2022 Dec 3.
BACKGROUND
Preventing inpatient falls is challenging for hospitals to improve and often leads to patient injury.
PURPOSE
To describe multifactorial patient-tailored interventions and to evaluate whether they were associated with a sustained decline in total and injury falls.
METHODS
A multifactorial fall prevention program was instituted over the course of several years. An interrupted time series design was used to assess the effect of each intervention on total and injury fall rates. ARIMA models were built to assess the step and ramp change.
RESULTS
Total fall rates decreased from 4.3 to 3.6 falls per 1000 patient days (16.28% decrease), and injury fall rates decreased from 1.02 to 0.8 falls per 1000 patient days (21.57% decrease). All the interventions contributed to fall reduction, with specific interventions contributing more than others.
CONCLUSIONS
Using multiple interventions that are sustained long enough to demonstrate success reduced the total fall rate and injury fall rate.
背景
预防住院患者跌倒对医院来说是一项具有挑战性的改进工作，且常常导致患者受伤。
目的
描述多因素个体化干预措施，并评估这些措施是否与总跌倒次数和受伤跌倒次数的持续下降相关。
方法
在数年时间里实施了一项多因素跌倒预防计划。采用中断时间序列设计来评估每项干预措施对总跌倒率和受伤跌倒率的影响。构建自回归整合移动平均模型（ARIMA）来评估阶跃变化和斜坡变化。
结果
总跌倒率从每1000个患者日4.3次跌倒降至3.6次跌倒（下降16.28%），受伤跌倒率从每1000个患者日1.02次跌倒降至0.8次跌倒（下降21.57%）。所有干预措施都有助于减少跌倒，其中特定干预措施的作用更为显著。
结论
采用持续足够长时间以证明成功的多种干预措施可降低总跌倒率和受伤跌倒率。
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