醫學中心住院病患之跌倒意外事件

目的：目的在針對住院病患跌倒事件之發生作深入探討，以瞭解住院病患跌倒事件之現況，及病患跌倒之因素分析。材料與方法：採回溯性調查研究法，以THIS (Taiwan Healthcare Indicator Series)跌倒意外事件報告單，收集中山醫學大學附設醫院，西元2002-2003年之病患跌倒意外事件進行分析比較。結果：計收取115位住院跌倒的病人，以男性(72.2%)居多、65歲以上發生佔所有跌倒病患的41.7%、復健科病患(38.3%)佔多數；跌倒狀況方面，以大夜班發生居多(40.5%)，其中尤以早上5-7點佔多數、跌倒時之活動以下床為主(26.1%)、跌倒時的活動動機以上廁所居多(32.1%)；跌倒發生原因中，病童跌倒發生導因主要是環境因素造成，而其它年齡層則是以生理因素為主，而跌倒所造成的傷害中，則以輕度傷害佔最多(47.8%)、次之為無傷害(33.9%)，中重度傷害最少(17.4%)。結論：病患可能會因錯綜複雜因素導致跌倒，所以護理人員應以病患的特質及疾病的病程，持續監測病患跌倒因子的評估及跌倒預防措施的給予及衛教，以減少住院病患跌倒的發生，而提昇以病患安全為中心的照護品質。
Purpose: This study was to identify causative factors leading to fall accidents in hospitals. Methods and Materials: This retrospective study uses chung shan medical university hospital reports to collect data on patients involved in fall accidents in a medical center hospital from 2002 to 2003. Results: One hundred and fifteen patients were recruited. Men had the most falls (72.2%), followed by the elderly (over 65 years old) (41.7%), and patients in rehabilitation wards (38.3%). As expected, most patients (40.5%) fell during the night shift (12 p.m. to 8 a.m.), especially between 5 a.m. and 7 a.m., when many falls were related to patients' attempting to get out of bed to use bathrooms. The major cause of fall accidents among children was environmental, whereas physical factors played a predominate role in the falls of patients at other ages. Falls caused mild injury (47.8%), no harm (33.9%), and serious injury (17.4%), respectively. Conclusion: Patients may fall for various reasons. Nurses can use the findings provided here to help them identify those most at risk of fall accidents and to provide individual intervention to reduce the rate of fall accidents in hospitals and make their stays safer.