Linkages between the safety of the hospital bed, patient falls and immobility

病床安全、患者跌倒和不动之间的联系

• 批准号: 8541801
• 负责人: Janice Margaret Morse
• 金额: $ 29.46万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2014-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8541801
• 关键词: Linkages; between; safety; hospital; bed

Fall intervention programs in hospitals and nursing homes are performing poorly, and many patients and residents still fall in hospitals and injure themselves. One aspect of the patient's environment that has not been systematically evaluated as a trigger for falls, is the hospital bed. In our pilot research, bed height, instability of the side rails, and the lack of a handhold for use when exiting the bed all contributed to fall risk. In this proposed study we will examine the relationships between bed height, the configuration of side rails, patient's physical characteristics and biomechanical forces that are exerted as the patient climbs in and out of bed. Sixty four participants, recruited from acute and long term care settings, will be videotaped as they interact with a bed that has been instrumented to measure patient strength requirements. Biomechanical, observational, and subjective participant data will be used to determine the optimal hospital bed height and side rail configurations to minimize the risk of falling and reduce the risk of injury. The biomechanical data will include joint torque during bed entry, exiting, and in-bed repositioning, as well as physical interactions between the patient, floor surface and hospital bed. Observed problems such as slips, balance checks, incomplete entry/exit, and near falls will be coded. Participants will provide a subjective assessment of their perception of fall risk associated with different bed heights and side rail configurations. We will also examine the side rail use for in-bed mobility. The ultimate goal of this research program is to develop design recommendations for a hospital bed that will enable the patient to enter the bed safely, to reposition themselves with minimal exertion, to stand with minimal effort at the bedside, and to move away from the bed with an optimally stable gait. This proposed research project addresses AHRQ's Patient Safety Mission to study the comparative effectiveness of important existing health care technologies, in this case the hospital bed. The development of a safe hospital bed will conservatively reduce bedside falls by 10%, thereby saving the healthcare system costs estimated at $1.5 billion per year in the prevention of injury by 2020.

医院和疗养院的跌倒干预计划效果不佳，许多患者和 居民仍然在医院里摔倒并受伤。患者环境的某一方面还没有 被系统评估为跌倒触发因素的是医院的病床。在我们的试点研究中，床的高度， 侧栏的不稳定性以及离开床时缺乏可用的把手都导致了跌倒风险。 在这项拟议的研究中，我们将研究床的高度、护栏的配置、 患者的身体特征以及患者爬进爬出时施加的生物力学力 床。从急性和长期护理机构招募的 64 名参与者将被录像 与已安装仪器来测量患者力量需求的床进行交互。生物力学， 观察和主观参与者数据将用于确定最佳医院床位高度和 侧轨配置可最大限度地减少跌倒风险并降低受伤风险。生物力学数据 将包括进入床、离开床和在床上重新定位期间的关节扭矩，以及物理相互作用 患者、地板表面和病床之间。观察到的问题，例如单据、余额检查、 不完整的进入/退出和接近跌倒将被编码。参与者将对其进行主观评估 对与不同床高度和护栏配置相关的跌倒风险的感知。我们还将检查 侧轨用于床上移动。该研究计划的最终目标是开发设计 对医院病床的建议，使患者能够安全地进入病床，重新定位 以最小的力气自己站立，以最小的力气站在床边，并离开床边 具有最佳稳定步态的床。该拟议研究项目旨在解决 AHRQ 的患者安全使命 研究现有重要医疗保健技术的比较有效性，在本例中 病床。开发安全的病床将保守地减少10%的床边跌倒， 从而为医疗保健系统节省估计每年 15 亿美元的预防伤害成本 2020.