Inpatient Fall Prevention Programs as a Patient Safety Strategy
Inpatient Fall Prevention Programs as a Patient Safety Strategy
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住院患者跌倒预防计划作为患者安全策略
DOI：
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发表时间：
2013
影响因子：
39.2
通讯作者：
P. Shekelle
中科院分区：
文献类型：
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作者：
Isomi M. Miake;S. Hempel;D. Ganz;P. Shekelle
福尔斯在住院病人中很常见。几项综述，包括4项涉及19项研究的荟萃分析，表明预防住院患者福尔斯的多组分计划可使福尔斯的相对风险降低30%。本次更新审查的目的是重新评估急性护理环境中跌倒预防计划的益处和危害，并确定与成功实施这些计划相关的因素。我们使用PubMed检索了2005年至2012年9月的新证据。两项新的大型随机对照试验支持现有荟萃分析的结论。没有确定最佳的组件组合。危害并未得到系统性检查，但潜在的危害包括更多地使用束缚和镇静药物以及减少动员患者的努力。11项研究表明，以下主题与成功实施相关：领导支持，参与一线工作人员的方案设计，由多学科委员会指导预防方案，试点测试干预措施，使用信息技术系统提供有关福尔斯的数据，工作人员的教育和培训，以及对跌倒预防的虚无主义态度的变化。未来的研究将通过为特定患者确定最佳组合的组件干预措施以及确定有效性是否更多地依赖于组件的组合或使用某些实施策略来推进知识。
Falls are common among inpatients. Several reviews, including 4 meta-analyses involving 19 studies, show that multicomponent programs to prevent falls among inpatients reduce relative risk for falls by as much as 30%. The purpose of this updated review is to reassess the benefits and harms of fall prevention programs in acute care settings and to identify factors associated with successful implementation of these programs. We searched for new evidence using PubMed from 2005 to September 2012. Two new, large, randomized, controlled trials supported the conclusions of the existing meta-analyses. An optimal bundle of components was not identified. Harms were not systematically examined, but potential harms included increased use of restraints and sedating drugs and decreased efforts to mobilize patients. Eleven studies showed that the following themes were associated with successful implementation: leadership support, engagement of front-line staff in program design, guidance of the prevention program by a multidisciplinary committee, pilot-testing interventions, use of information technology systems to provide data about falls, staff education and training, and changes in nihilistic attitudes about fall prevention. Future research would advance knowledge by identifying optimal bundles of component interventions for particular patients and by determining whether effectiveness relies more on the mix of the components or use of certain implementation strategies.