| 摘要: | 病人可能因為跌倒導致不同嚴重程度的傷害，輕則活動力降低，重則危及生命安全。本研究收案的地區醫院綜合科病房所發生的意外事件中以跌倒發生率最高，跌倒除了造成病人心理影響外，對生理的影響更鉅；由於跌倒事件的發生是由許多因素相互影響所造成，故研究目的在探討綜合科病房病人跌倒之特性，並確立影響病人傷害性跌倒之相關因素，以異常事件資訊檔案回溯，收集南部某地區醫院綜合科病房2013年1月1日至2014年11月30日病人跌倒事件，以描述性統計、卡方檢定、邏輯斯迴歸進行資料統計分析。 統計結果(1)跌倒事件描述性統計發現病人跌倒情形:年齡71歲以上、步態不穩、住院期間有家人或照顧者陪伴、照護班別大夜班、無使用輔具、跌倒地點於病床旁、住院天數1-3天發生跌倒最多；(2)傷害性跌倒卡方檢定發現:住院病人傷害性跌倒相關因素以眩暈、自我照顧能力達顯著差異(P<0.05)；(3)邏輯斯迴歸分析發現:眩暈與傷害性跌倒呈現負相關(P=0.044，OR=0.185)，有眩暈病人發生傷害性跌倒是無眩暈的0.185倍；自我照顧能力與傷害性跌倒呈現正相關(P=0.044，OR=13.25)，部分依賴發生傷害性跌倒是可自我照顧的13.25倍。 本研究結果發現眩暈及自我照顧能力與傷害性跌倒有相關，建議列入臨床護理人員評估高危險性跌倒病人及降低傷害性跌倒之參考，並針對此類病人提供如廁輔具與活動輔具，另外衛教病人採漸進式下床，避免因活動姿勢改變造成眩暈。
Patients may result in different severity of injuries due to fall. It may cause reduced activity or the life-threatening. The cases collected from the regional hospital comprehensive wards of this study had the highest incidence of falls among all accidents. In addition to causing psychological impact, falls may make a patient the more impact on the physiology. As a result of the fall events are caused by the interaction of many factors, this study aimed at investigate the characteristics of patient of falls at comprehensive wards and established the relevant factors of falls of patient harm. Using abnormal event files to make retrospective collections, it was from January 1, 2013 to November 30, 2014 incident patient falls at comprehensive wards of a hospital in a southern local community hospital. The statistical methods used are descriptive statistics, chi-square test, and logistic regression statistical analysis. The statistical results are:(1) Descriptive statistics of fall event: Age seventy-one and older, unsteady gait, during hospitalization having family or caregivers accompany, night shift, unused aids, fall place beside the bed, and hospital stay one to three days have the larger rate of fall occurred; (2) The chi-square test of injurious falls: For injurious falls, the related factors such as vertigo, self-care ability for inpatient were statistically significant risk factors (P<0.05); (3) Logistic regression: The vertigo factor and the factor of injurious falls are significantly negative correlation(P=0.044,OR=0.185), and the odds ratio of vertigo patients of injurious falls is 0.185 times of no vertigo. The self-care ability factor and the factor of injurious falls are significantly positive correlation (P=0.044,OR=13.25), and the odds ratio of partially dependent patients of injurious falls is 13.25 times of the self-care of themselves. The results of this study, dizziness and self-care skills are related with injurious falls, can provide some references as clinical nurses to assess patients at high risk of falls and to down the cases of injurious falls. To avoid posture change causing dizziness, for such patients we suggest to provide urination and defecation aids and activities auxiliary tool, and to give patient health education adopting progressively off the bed. |
