降低學齡前期住院病童跌倒發生率

Reduction of Fall Incidence of Preschool Pediatric Patients During Hospitalization

病童住院期間跌倒是本單位意外事件最高項目，造成病童、家屬及護理人員極大身心壓力，本專案旨在降低學齡前期住院病童跌倒發生率。經分析跌倒發生原因並確立問題為環境不符合病童安全設計、設備不符合病童安全設計、家屬對預防跌倒認知及警覺性不足、未察覺病童正處於跌倒高峰期且未提供適切防範措施、指導單張內容不夠詳盡、未評值及追蹤家屬防跌成效。經更改遊戲室無障礙地面、設計兒童專用防跌標誌圖卡、設計兒童專用安全輪椅、依年齡規範適用輪椅準則、製作警示標語、修訂指導單張、團體衛教、篩選跌倒高峰期病重並引導遊戲進行及將預防跌倒納入護理計畫等策略後，學齡前期病童跌倒發生率由0.13%降至0.04%達專案目標。

The fall rate of hospitalized pediatric patients is the highest among all accidents in Pediatric ward, resulting in tremendous stress for pediatric patients, their families and nursing professionals. This project aims to reduce the fall incidence of preschool pediatric patients during hospitalization. After data collection and analysis, causes for fall include non-conforming environment and equipment to safety design, insufficient cognition and alterness for fall prevention of family members, unwareness of the peak of falling and no provision of precautions, insufficiency of instruction, lack of appraisal and follow-up regarding the effectiveness of fall prevention of family members. Improvement strategies were implemented to reduce fall incidence. The barrier free floor was built in the playroom. The logo for fall prevention was designed and pediatric wheelchairs were specially designed for safety with terms of use according to different ages. Warning signs for fall were made. Instruction was revised and group education was conducted. Preschool pediatric patients at high risk of fall were screened and guided to enter the playroom. Fall prevention was included in nursing care plans. After implementation, the fall incidence of preschool pediatric patients during hospitalization was reduced from 0.13% to 0.04%.