運用多元措施降低老年病房的跌倒發生率

Multi-Intervention Measure for Reducing the Incidence of Falls among Elderly Patients

本單位在2018至2020年發生84件跌倒，跌倒發生率0.14%；其中65歲（含）以上老年病人跌倒66件（佔78.86%），發生率0.17%。老年病人會因跌倒造成負向身心影響，也會產生後續健康問題，引發動機。本專案目的為降低老年住院病人跌倒發生率。確認跌倒原因有：下肢肌力變弱致步態不穩、24小時點滴滴注增加夜尿頻率、自認能力可行執意下床、主要照顧者離開病人不會告知護理師及確認設備。故擬定6項多元介入措施：使用彈力帶、床上腳踏車、減少夜間點滴、登記夜尿時間點，主動協助、使用臨床衰弱量表於入院評估、增加預防跌倒團體衛教場次。追蹤2021至2023年共發生4件跌倒，總跌倒發生率為0.01%；老年病人跌倒1件（發生率小於0.01%(0.004%）。本專案不僅降低老年病人跌倒發生率，也提升病人安全。

 

Falls compromise the physical and mental well-being of elderly, leading to prolonged health problems. Between 2018 and 2020, 84 falls were recorded in our geriatric ward, resulting in an overall incidence rate of 0.14%. Among these falls, 66 (78.86%) occurred in elderly patients (incidence rate: 0.17%). In this study, we evaluated the efficacy of multi-intervention measures in reducing the incidence of falls among elderly inpatients. Confirmed reasons for falls in this population are as follows: weak lower limb muscles leading to an unsteady gait, 24-h intravenous infusion increasing the frequency of nocturia, overconfidence resulting in patients insisting on getting out of bed, and caregivers leaving patients unattended without informing the nurse or ensuring that safety equipment is in place. Eligible elderly patients received a multi-intervention combining the following six interventions: using elastic bands, cycling in bed, reducing nighttime intravenous drips, recording nocturia time points and providing active assistance, administering the clinical frailty scale upon admission, and increasing group health education sessions on fall prevention. Between 2021 and 2023, four falls were recorded in our geriatric ward; the overall incidence rate was 0.01%. Among elderly inpatients, the incidence rate was 0.004%. Therefore, the multi-intervention measures successfully reduced the incidence of falls in the geriatric ward, particularly among elderly inpatients.