住院患者跌倒的根本原因分析及对策

摘要

Objective:To analyze the causes and features of hospitalized patients’ falls,to explore the countermeasures of reducing falls and to improve patient safety.Method:8 patients with falls were retrospectively analyzed,used the root cause analysis(RCA) analysis of the causes of the fall.Result:About 62.5% patients were over 65 years old.Totally falls were movement disorder.Falls incident occurred in the night and at the bedside.The risk factors of falls included insufficient assessing abilities of nurses and doctors,safety awareness of patients and their families,inadequate preventive measures and training,poor compliance,and slippery floor and other environmental factors.Conclusion:The fundamental countermeasures of reducing falls are to strengthen preventive training of falls,to improve safety awareness,to strengthen safety management and communication with patients and their families,continuously to improve care measures to reduce the incidence of falls in hospital.%目的：分析住院患者发生跌倒的原因及特点，探讨减少住院患者跌倒的发生，提高患者安全的有效管理。方法：对8例发生跌倒的患者进行回顾性分析，用根本原因分析法(RCA)分析发生跌倒的原因。结果：发生跌倒的患者年龄≥65岁的占62.5%；多有活动障碍；跌倒事件多发生在夜班、床旁；发生跌倒的主要原因与医护人员评估不全面、患者及家属安全意识不强、依从性差、医院相关培训不足及地面湿滑等环境因素有关。结论：应从加强人员培训、提高安全防范意识、加强跌倒的安全管理及与患者及家属的沟通着手，不断改进护理措施，减少住院患者跌倒的发生。