Fisch H P
Aktuelle Gerontol. 1983 Jul;13(4):146-8.
61 falls and accidents and one suicide needed medical attention in our nursing home during a five-year period. Most frequent sequelae were scalp lacerations, followed by fractures of the femoral neck. 73% of the patients who got hurt by falls suffered of dementia. 38% were being treated with neuroleptic, antihypertensive or diuretic drugs. It was not possible however to document a relationship between drug treatment and falls. Most falls occurred while patients were walking on the floor without obstacles and without external influences. 3 patients died as immediate consequence of their falls. We observed falls more often in the first period of the patient's stay in our institution and again shortly before the patient's death. Prophylactic measures against falls include bed-rails, little tables that can be fixed to the wheel-chairs in order to hinder unassisted standing up of patients, unable to walk alone and judicious treatment with sedative drugs. The most important measure however seems to be compassionate and attentive patient care that conveys trust and confidence between patients and the nursing personnel. Possibly the incidence of falls and accidents could be used as a measure of the quality of nursing care in geriatric institutions.
在五年期间，我们养老院发生了61起跌倒和事故，还有1起自杀事件需要医疗救治。最常见的后遗症是头皮裂伤，其次是股骨颈骨折。跌倒受伤的患者中有73%患有痴呆症。38%的患者正在接受抗精神病药、抗高血压药或利尿药治疗。然而，无法证明药物治疗与跌倒之间存在关联。大多数跌倒发生在患者在没有障碍物且没有外部影响的情况下在地面行走时。3名患者因跌倒直接死亡。我们观察到，在患者入住我们机构的第一阶段以及在患者死亡前不久，跌倒情况更为频繁。预防跌倒的措施包括床栏、可固定在轮椅上以防止无法独自行走的患者自行站立的小桌子，以及谨慎使用镇静药物。然而，最重要的措施似乎是给予患者富有同情心和贴心的护理，在患者与护理人员之间传递信任。跌倒和事故的发生率可能可用作衡量老年机构护理质量的一个指标。
