风险因素和预防策略之间的差距？中国内外科患者跌倒预防调查 | J Adv Nurs

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共同成长

Abstract

Aims

This study aimed to determine the extent to which nurses report assessing evidence-based falls risk factors and implementing targeted prevention for medical and surgical patients in China.

Design

This study was a national online survey.

Methods

The respondents were registered nurses working in medical and surgical units in 662 Chinese hospitals. The data concerning the falls risk factor assessments and targeted interventions implemented by nurses were collected online by the Nursing Management Committee of the Chinese Nursing Association in China in 2019.

Results

In total, 68 527 valid questionnaires were returned (95.0%). In medical and surgical units, nurses were most likely to report assessing balance, mobility and strength (81.6%) and orthostatic hypotension (76.4%) in falls patients and least likely to report assessing continence (61.3%) and feet and footwear (55.8%). Ensuring the use of appropriate footwear (79.3%) and managing syncope, dizziness and vertigo (73.8%) were the most common multiple interventions, while managing postural hypotension (48.8%) and cognitive impairment (48.4%) was the least common. Nine falls risk factors with clearly matched multifactorial interventions were identified in medical and surgical units (68.2%–97.1%).

Conclusions

The implementation of multifactorial interventions in medical and surgical wards is inconsistent as reported by nurses in medical and surgical wards. Throughout China, nurses are generally concerned about falls risk factors and prevention for their patients; however, limited attention has been focused on continence, feet and footwear assessment and the management of cognitive impairment. Evidence-based falls prevention should be further tailored to the specific risk factors of each patient.

Impact

Best practice guidelines for falls prevention in hospitals have been developed and published, and it is important for nurses to use these guidelines to guide practice. Our findings identify that in routine care, healthcare providers and hospitals can prevent falls.

摘要翻译（仅供参考）

目标

本研究旨在确定护士报告评估循证跌倒危险因素和实施针对内科和外科患者的针对性预防的程度。

设计

这项研究是一项全国性的在线调查。

方法

受访者是在中国 662 家医院的医疗和外科单位工作的注册护士。2019年中国护理学会护理管理委员会在线收集护士跌倒危险因素评估及针对性干预措施数据。

结果

共回收有效问卷68 527份（95.0%）。在医疗和外科单位，护士最有可能报告评估跌倒患者的平衡、活动能力和力量（81.6%）和直立性低血压（76.4%），而最不可能报告评估失禁（61.3%）和足部和鞋类（55.8%） ）。确保使用合适的鞋类 (79.3%) 和管理晕厥、头晕和眩晕 (73.8%) 是最常见的多重干预措施，而管理体位性低血压 (48.8%) 和认知障碍 (48.4%) 是最不常见的。在内科和外科单位确定了 9 个跌倒风险因素与明确匹配的多因素干预措施 (68.2%–97.1%)。

结论

正如内外科病房护士所报告的那样，内外科病房多因素干预措施的实施情况不一致。在整个中国，护士普遍关注患者跌倒的危险因素和预防措施；然而，对节制、足部和鞋类评估以及认知障碍管理的关注有限。循证跌倒预防应进一步针对每位患者的特定风险因素进行调整。

影响

医院预防跌倒的最佳实践指南已经制定和发布，护士使用这些指南指导实践非常重要。我们的研究结果表明，在日常护理中，医疗保健提供者和医院可以预防跌倒。

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