Zhang Qi, Wei Dan, Gao Yueshan, Jiang Tingting, Chen Qian
Geriatrics Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China.
Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Jul;54(4):804-810. doi: 10.12182/20230760601.
To examine the application effect of risk management combined with precision nursing in the maintenance of physical functions and the safety management of older patients with chronic diseases and to provide the basis for the formulation of physical function maintenance and fall prevention programs for older inpatients with chronic diseases.
The control group and the observation group were randomly selected by cluster sampling from geriatric wards of similar conditions in West China University, Sichuan University. The control group received conventional nursing care and the observation group had risk management combined with precision nursing on top of the conventional nursing care. The primary outcome indicator was activities of daily living (ADL). The secondary outcome indicators were the whole-day ambulation time and infusion time, the incidence of falls, and length-of-stay among patients.
A total of 109 patients in the control group and 110 patients in the observation group completed the study. At the time of admission, there was no statistically significant difference between the ADL scores of the two groups ( >0.05). Among the patients in the intervention group, the post-intervention ADL scores of the observation group (75.74±22.71) were higher than the pre-intervention ADL scores (68.74±17.32) and the difference was statistically significant ( =2.435, <0.05). Among the patients in the control group, the post-intervention ADL scores of the control group (70.36±21.90) were higher than the pre-intervention ADL scores (69.14±18.29) and the difference was not statistically significant ( =0.549, >0.05). In addition, the post-intervention ADL score of the observation group was higher than that of the control group, and the difference was statistically significant ( =2.973, <0.05). After intervention, patients in the observation group had higher whole-day ambulation time during hospitalization (7.35±2.07) than those in the control group did (4.11±2.62), showing significant difference ( =1.508, <0.05). The whole-day infusion time during hospitalization of the observation group (1.68±0.19) was lower than that of the control group (2.39±0.31), showing significant difference ( =-2.339, <0.05). There was no significant difference in the incidence of falls or the length-of-stay between the two groups ( >0.05).
Risk management combined with precision nursing helps improve patients' ability to perform activities of daily in older patients with chronic diseases, increase their whole-day ambulation time, and reduce the whole-day infusion time without increasing the incidence of falls, which has a positive effect on physical function maintenance and fall prevention in hospital safety management of older patients with chronic diseases.
探讨风险管理联合精准护理在老年慢性病患者身体功能维持及安全管理中的应用效果，为制定老年慢性病住院患者身体功能维持及预防跌倒方案提供依据。
采用整群抽样法从四川大学华西医院条件相近的老年病房中随机抽取对照组和观察组。对照组接受常规护理，观察组在常规护理基础上实施风险管理联合精准护理。主要结局指标为日常生活活动能力（ADL）。次要结局指标为患者全天活动时间、输液时间、跌倒发生率及住院时间。
对照组109例患者、观察组110例患者完成研究。入院时，两组ADL评分比较差异无统计学意义（>0.05）。干预组中，观察组干预后ADL评分为（75.74±22.71）分，高于干预前（68.74±17.32）分，差异有统计学意义（=2.435，<0.05）。对照组中，对照组干预后ADL评分为（70.36±21.90）分，高于干预前（69.14±18.29）分，差异无统计学意义（=0.549，>0.05）。此外，观察组干预后ADL评分高于对照组，差异有统计学意义（=2.973，<0.05）。干预后，观察组患者住院期间全天活动时间（7.35±2.07）高于对照组（4.11±2.62），差异有统计学意义（=1.508，<0.05）。观察组住院期间全天输液时间（1.68±0.19）低于对照组（2.39±0.31），差异有统计学意义（=-2.339，<0.05）。两组跌倒发生率及住院时间比较差异无统计学意义（>0.05）。
风险管理联合精准护理有助于提高老年慢性病患者的日常生活活动能力，增加其全天活动时间，减少全天输液时间，且不增加跌倒发生率，对老年慢性病患者住院安全管理中的身体功能维持及预防跌倒具有积极作用。
