Call Light Responsiveness and Effect on Inpatient Falls and Patient Satisfaction

描述(由申请人提供)：住院患者跌倒可能导致受伤、长时间停留、缺乏患者独立性和额外的资源消耗。这项研究计划的长期目标是了解导致跌倒的因素，并开发和测试预防跌倒的干预措施。关于护理人员对病人呼叫灯的反应时间的研究很少，因为它有助于预测病人摔倒。这个项目扩展了PI关于住院患者跌倒风险因素的初步发现，特别是关于呼叫灯的使用和反应时间与跌倒和患者满意度的关系。这项研究的具体目的是检验呼叫光响应时间在预测中的独特贡献：1)总跌倒率，2)损伤性跌倒率，3)患者对呼叫光响应性的感知。我们将使用2002年1月至2008年12月的存档医院数据/报告分析来自四家密歇根州医院(三家教学医院和一家社区医院)的32个单位的数据。数据将从存档的医院数据/报告中提取，并将使用多元回归分析来解决以下假设：h1)呼叫灯光响应时间将显著有助于预测跌倒发生率。H2)呼叫灯响应时间将对预测伤害性坠落率有很大贡献。H3)呼叫灯响应时间对预测患者对呼叫灯响应性的感知有显著贡献。因变量为总坠落率、损伤性坠落率和患者对呼叫灯响应性的感知。主要自变量是呼叫灯响应时间。控制变量为医院、病房类型、呼叫灯使用率、病人日总护理小时数(HPPDs)和RNS提供的总护理HPPDs的百分比。对于回归分析，患者护理单位月将是定义为每个患者护理单位按月汇总的数据的分析单位。样本量(N=2688)将提供足够的统计能力。这一多医院研究设计的结果将增加对多个成人住院急性护理病房中工作人员对灯光和跌倒的反应时间与患者感知之间的关系的理解，并将为未来的描述性和干预性研究奠定基础。长期目标是促进住院患者更安全的住院时间，包括减少住院患者摔倒和跌伤。

DESCRIPTION (provided by applicant): Inpatient falls can lead to injury, prolonged stays, lack of patient independence, and additional resource expense. The long-term goal of this program of research is to understand factors that contribute to falls and to develop and test interventions to prevent them. Little research has been done on the nursing staff's response time to patient call lights as it contributes to predicting patient falls. This project extends the PI's preliminary findings on the risk factors for inpatient falls, and specifically on the relationship of the call light usage and response time to falls and patient satisfaction. The specific aims of this proposed study are to examine the unique contribution of call light response time in predicting: 1) total fall rates, 2) injurious fall rates, and 3) patients' perceptions about call light responsiveness. We will analyze data from 32 units from four Michigan hospitals (three teaching hospitals and one community hospital) using archived hospital data/reports from January 2002 to December 2008. Data will be abstracted from the archived hospital data/reports and multiple regression analyses will be used to address the following hypotheses: H1) Call light response time will contribute significantly to predicting fall rates. H2) Call light response time will contribute significantly to predicting injurious fall rates. H3) Call light response time will contribute significantly to predicting patients' perceptions about call light responsiveness. The dependent variables are the total fall rate, injurious fall rate, and patients' perceptions about call light responsiveness. The primary independent variable is call light response time. The control variables are the hospital, unit type, call light use rate, total nursing hours per patient-day (HPPDs), and percent of the total nursing HPPDs supplied by RNs. For the regression analyses, the patient care unit-month will be the unit of analysis defined as data aggregated by month for each patient care unit. The sample size (N=2688) will provide adequate statistical power. Findings from this multi-hospital study design will increase the understanding of the relation between staff response time to call lights and falls and patient perceptions in multiple adult inpatient acute care units and will lay the foundation for future descriptive and intervention studies. The long-term goal is to promote safer hospital stays for inpatients, including fewer inpatient falls and fall injuries.