運用多元策略降低急診後送病房病人跌倒之發生率

Adoption of Multiple Strategies to Reduce the Incidence of Falls Among Patients in Acute care Units

目的：
病人跌倒會造成不同程度的傷害，影響身體功能與獨立活動能力，本專案主要目的為降低急診後送病房病人跌倒發生率。
方法：
經現況分析，急診後送病房病人跌倒發生率為0.08％，確立問題為病人及主要照顧者認知不足、未正確使用便盆椅/輪椅、語言溝通障礙、缺外語指導單張及地板濕滑。改善措施包括：預防跌倒團體衛教、製作（中英印）個別化的高危/超高危預防跌倒措施檢核表、張貼『拉上床欄、預防跌倒」及「高風險跌倒者嚴禁下床」警示語、篩選並提供院內多國語言預防跌倒的護理指導影片（含QR code），增設多國語言預防跌倒護理指導之全病房廣播系統，制定便盆椅/輪椅防跌四步驟說明標語，定期調控每間浴室蓮蓬頭水壓大小及更換地板浴廁門口止滑條。
結果：
急診後送病房病人跌倒發生率由0.08％降至0.06％。
結論：
經由多元預防跌倒策略，降低急診後送病房病人跌倒發生率。運用高科技機器人協助護理師進行入院環境介紹及高危跌倒的護理指導，減少護理師工作負荷及時間，護理師將專注於病人個別性的照護，優化護理品質。

Purposes:
Falls can cause varying degrees of injury in patients and affect their physical function and ability to perform activities independently. The main purpose of this project was to reduce the incidence of falls among patients in acute care units.
Methods:
The current incidence of falls among patients in acute care units is 0.08% at Jan to June in 2020. The following have been identified as contributing factors: lack of knowledge in patients and their primary caregivers, improper use of commode chairs/ wheelchairs, language barriers, lack of information leaflets in foreign languages, and slippery floors. Improvement measures included the following: group health education on falls prevention, development of individualized checklists (in Chinese, English, and Indonesian) of falls prevention measures for high-risk/extremely high-risk individuals, placement of the warning signs“Keep bed rails raised to prevent falls”and“Bed exit is strictly disallowed for patients at high risk for falls,”screening and provision of nursing guidance videos on falls prevention in various languages (including QR codes), provision of nursing guidance on falls prevention in different languages through ward announcements over the public announcement system, creation of four-step instruction graphics for falls prevention during commode chair/wheelchair use, regular adjustment of water pressure in the shower head of every bathroom, and regular replacement of anti-slip strips on bathroom floors.
Results:
From July 1to December 31, the current incidence of falls dropped from 0.08% to 0.06% among patients in acute care units.
Conclusions:
The adoption of multiple falls prevention strategies lowered the incidence of falls among patients in acute care units. The workload and time spent by nurses can be effectively reduced by using high-tech robots to assist them in providing an overview of the hospital environment to patients during admission and nursing guidance to individuals at high risk of falls. This enables nurses to focus on individualized patient care and the optimization of nursing care quality.