Fall Prevention Practices and Implementation Strategies: Examining Consistency Across Hospital Units.
Fall Prevention Practices and Implementation Strategies: Examining Consistency Across Hospital Units.
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DOI：
10.1097/pts.0000000000000758
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发表时间：
2022-01-01
影响因子：
2.2
通讯作者：
Mion LC
中科院分区：
文献类型：
--
作者：
Turner K;Staggs VS;Potter C;Cramer E;Shorr RI;Mion LC
我们的研究探讨了美国医院如何始终如一地使用跌倒预防实践和实施策略。我们对60家成人综合医院进行了一项横断面描述性研究。我们进行了一项调查，测量跌倒预防实践的5个领域：可见性和识别，床的修改，病人监护，病人安全和教育。我们测量了实施战略的4个领域，包括质量管理（例如，为质量改进提供数据和支持），规划（例如，指定领导），教育（例如，提供咨询和培训），以及重组（例如，修改人员角色和修改设备）。在60个单位中，43%是医疗单位，57%是内外科单位。医院单位在预防跌倒的实践中各不相同，例如将患者的床保持在锁定位置（73%的人强烈同意）的做法比其他做法更一致，例如计划的排队（15%的人强烈同意）。我们的研究观察到跌倒预防实施策略的变化。例如，公开发布跌倒率（60%的人强烈同意）比跌倒事件后进行多学科聚集（12%的人强烈同意）更一致。在实施跌倒预防措施和实施策略方面，各住院单位存在很大差异。我们的研究发现，资源密集型做法（例如，与资源密集程度较低的做法相比，计划性的跌倒预防措施的使用不那么一致，而且预防跌倒的跨学科方法也很有限。未来的研究应检查单位如何根据患者的风险因素定制跌倒预防措施，以及单位如何根据其可用资源决定应使用哪些实施策略。
Our study examines how consistently fall prevention practices and implementation strategies are used by U.S. hospitals. We conducted a cross-sectional, descriptive study of 60 general adult hospital units. We administered a survey measuring 5 domains of fall prevention practices: visibility and identification, bed modification, patient monitoring, patient safety, and education. We measured 4 domains of implementation strategies including quality management (e.g., providing data and support for quality improvement), planning (e.g., designating leadership), education (e.g., providing consultation and training), and restructuring (e.g., revising staff roles and modifying equipment). Of 60 units, 43% were medical units and 57% were medical-surgical units. The hospital units varied in fall prevention practices, with practices such as keeping a patient’s bed in a locked position (73% strongly agree) being used more consistently than other practices, such as scheduled toileting (15% strongly agree). Our study observed variation in fall prevention implementation strategies. For example, publicly posting fall rates (60% strongly agree) was more consistently used than having a multidisciplinary huddle after a fall event (12% strongly agree). There is substantial variation in the implementation of fall prevention practices and implementation strategies across inpatient units. Our study found that resource-intensive practices (e.g., scheduled toileting) are less consistently used than less resource-intensive practices and that interdisciplinary approaches to fall prevention are limited. Future studies should examine how units tailor fall prevention practices based on patient risk factors and how units decide, based on their available resources, which implementation strategies should be used.