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Use of Incident Reports to Assess Falls in Nursing Homes

使用事故报告来评估疗养院的跌倒情况

基本信息

批准号：
6845840
负责人：
LAURA M WAGNER
金额：
$ 1.42万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-09-01 至 2004-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6845840
关键词：
accidental falls clinical research computer program /software data collection methodology /evaluation frail elderly human subject injury prevention medical records nurse performance nursing homes patient care planning

项目摘要

DESCRIPTION (provided by the applicant): The purpose of this dissertation research is to test the effect of a systematically guided, menu-driven incident reporting system (MDIRS) on the post fall evaluation process in nursing homes (NHs). Falls among frail NH residents are a common and potentially preventable problem that results in adverse economic, medical, and psychological consequences. Approximately one-half of the 1.7 million NH residents fall annually. When a NH resident falls, the licensed nurse documents the incident both in the medical record and incident report. Traditionally, the incident report serves a dual purpose in NHs-risk management and liability, but it is seldom used for quality improvement. Incident reporting systems have been successfully used as a model to reduce errors and improve safety in several disciplines, but their use in improving the quality of care in NHs has not been examined. This study aims to improve the content and systematic structure of a falls incident report with the overall goal of enhancing the quality of care that nurses provide to NH residents. A secondary goal is to explore the feasibility in entering the MDIRS falls information in a computer software program to facilitate aggregate analysis of data for quality improvement initiatives. The broad, long term objective of this study is to provide a foundation for a program of research aimed at improving the safety among NH residents. The study is a six-month pretest-posttest experimental design to examine the effect of the MDIRS on the post-fall evaluation process in NHs. The candidate has successfully recruited six NHs (3 intervention; 3 control) in the metropolitan Atlanta area to participate in the study. Medical record documentation of residents who fall during the six month study period will be examined. By conducting a structured process-of-care audit based on clinical practice guidelines, the candidate will test whether the NH staff utilizing the MDIRS intervention improves how NH staff systematically assess residents in the post-fall evaluation period. The results of this study may lead to improved methods for post-fall assessment in NHs.

描述（由申请人提供）：本论文研究的目的是测试系统指导，菜单驱动的事件报告系统（MDIRS）对养老院（NHs）跌倒后评估过程的影响。在身体虚弱的新西兰居民中，跌倒是一种常见的、潜在的可预防的问题，它会导致不利的经济、医疗和心理后果。大约有一半的170万新罕布什尔州居民每年下降。当NH居民跌倒时，持牌护士将事故记录在医疗记录和事故报告中。传统上，事故报告在nhs风险管理和责任方面具有双重作用，但很少用于质量改进。事故报告系统已经成功地作为一个模型，以减少错误和提高安全在几个学科，但他们在提高护理质量在NHs的使用尚未被检查。本研究旨在改善跌倒事件报告的内容和系统结构，总体目标是提高护士提供给NH居民的护理质量。第二个目标是探索在计算机软件程序中输入MDIRS下降信息的可行性，以促进数据的综合分析，以促进质量改进计划。本研究的广泛、长期目标是为旨在提高NH居民安全的研究计划提供基础。该研究是一项为期六个月的前测后测实验设计，旨在检查MDIRS对NHs中跌倒后评估过程的影响。候选人在亚特兰大大都会地区成功招募了6个NHs（3个干预，3个对照）参与研究。在六个月的研究期间跌倒的居民的医疗记录文件将被检查。通过根据临床实践指南进行结构化的护理过程审计，候选人将测试NH工作人员是否使用MDIRS干预措施改善了NH工作人员在秋季后评估期间系统评估居民的方式。这项研究的结果可能会导致NHs摔倒后评估的改进方法。