降低長期照顧機構失智住民跌倒發生率之專案

A Project to Prevent Fall Among Dementia Resident Living in a Long-Term Care Facility

本專案目的在於降低某長照機構失智住民跌倒發生率。經統計本機構2010年跌倒發生率0.03%（4件），至2011年跌倒發生率劇增為0.1%（14件），分析原因主要為護理人員未落實預防跌倒流程作業、照服員認知及技能缺失、代班照服員不熟悉住民特性與工作內容、跌倒高危險群圖片標示不明顯。藉由成立專案小組，與跨專業團隊共同分析原因、檢討及問題解決方案執行，並依住民個別性給予預防照護措施，專案執行後，在2012年9月至12月跌倒發生率0%，並持續效果維持，達成預防跌倒之病人安全工作目標。

The purpose of this project was to prevent fall among dementia residents in a long term care facility. During 2010, the rate of fall in a long-term care facility was 0.03%, but increased to 0.1% in 2011. The causes of fall among dementia residents were incorrect ways of performing fall prevention standard process among nurses, lack of fall prevention perceptions and skills among nursing assistants, unfamiliar residents and working contents among substitute nursing assistants,and unclear documentations of high risk of fall. Therefore, a project team aimed atreducing fall rate of the unit was organized. By working with health care provider team, the causes of fall were found and problem solving methods were planned and executed. Finally, the rate of fall betweenSeptember to December 2012 was 0%. However, to prevent fall among dementia residents living in a long-term care facility, health care provider should work together as a team.