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中国养老院中的不良事件及促成因素:一项多地点横断面研究。

Adverse events and contributing factors in Chinese nursing homes: a multisite cross-sectional study.

作者信息

Wang Zhangan, Qi Xiang, Shi Ying, Shao Lu, Li Wei, Xie Xiyan, Wu Bei, Zhang June

机构信息

Department of Health Management, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Rory Meyers College of Nursing, New York University, New York, NY, United States.

出版信息

Front Public Health. 2025 Feb 25;13:1518552. doi: 10.3389/fpubh.2025.1518552. eCollection 2025.

Abstract

BACKGROUND

Adverse events in nursing homes, which are unintended incidents causing unnecessary harm to older residents. Previous studies in Chinese populations often focused on adverse events in hospitals, rather than residents in nursing homes. Additionally, they tended to focus on single incident rather than multiple types of adverse events. This study aims to assess the occurrence and contributing factors of multiple adverse events perceived by staff in Chinese nursing homes.

METHODS

A cross-sectional survey was conducted among 691 frontline staff from 11 nursing homes in Southern China (August 2021-January 2022). Data were collected using a General Information Questionnaire, the Adverse Event Reporting Awareness Scale, and the Adverse Event Reporting Habit Scale. Logistic regression models were employed to analyze the contributing factors of adverse events.

RESULTS

A total of 13 types of adverse events were screened out in nursing homes, and 477 (69.0%) participants reported that the adverse events "had happened" in the past year. The most common events were falls, unplanned extubation, and pressure sores. Clinical staff were 2.06 times more likely than frontline workers to report adverse events (95% CI = 1.13-3.76). Increased awareness (OR = 1.24, 95% CI = 1.15-1.34) and habitual reporting of adverse events (OR = 1.04, 95% CI = 1.01-1.08) were positively associated with higher reporting rates.

CONCLUSION

A significant proportion of staff reported adverse events, with clinical staff and those with better reporting habits noting higher occurrences. To enhance resident safety, nursing homes must prioritize preventing high-risk adverse events. Targeting frontline workers with lower reporting awareness and habits is crucial for effective interventions.

摘要

背景

养老院中的不良事件是对老年居民造成不必要伤害的意外事件。以往针对中国人群的研究通常关注医院中的不良事件,而非养老院中的居民。此外,这些研究往往侧重于单一事件,而非多种类型的不良事件。本研究旨在评估中国养老院工作人员所感知的多种不良事件的发生情况及其影响因素。

方法

对来自中国南方11家养老院的691名一线工作人员进行了横断面调查(2021年8月至2022年1月)。使用一般信息问卷、不良事件报告意识量表和不良事件报告习惯量表收集数据。采用逻辑回归模型分析不良事件的影响因素。

结果

养老院共筛查出13种不良事件,477名(69.0%)参与者报告在过去一年中“发生过”不良事件。最常见的事件是跌倒、意外拔管和压疮。临床工作人员报告不良事件的可能性是一线工作人员的2.06倍(95%CI=1.13-3.76)。不良事件报告意识的提高(OR=1.24,95%CI=1.15-1.34)和习惯性报告(OR=1.04,95%CI=1.01-1.08)与更高的报告率呈正相关。

结论

相当一部分工作人员报告了不良事件,临床工作人员和报告习惯较好的人员报告的发生率更高。为提高居民安全性,养老院必须优先预防高风险不良事件。针对报告意识和习惯较低的一线工作人员进行干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/471a/11893384/f683c42a0427/fpubh-13-1518552-g001.jpg

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