Assessment of Risk Factors and Early Intervention of Tumble in Patients with Mental Disorders_West China Medical Journal

Authors：

 ZHANGZhuo-qiu ¹ , JIANGWei ² , ZUOXiao-feng ¹

1. Mental Health Center;West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Renal Dialysis Center;West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

Mental disorders; Tumble assessment; Tumble prevention

DOI：

10.7507/1002-0179.20150150

Video：

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Objective To compare the application of self-made tumble risk factors assessment scale before and after its revision in patients with mental disorder, in order to guide the clinical work. Methods We retrospectively analyzed the clinical data of 2 209 patients with mental disorders who were discharged from the hospital between January 1, 2012 and December 31, 2013. All the patients in our hospital underwent the assessment by "table of tumble risk factors for hospitalized patients and nursing measures" within one hour of admission. A total score of 4 or higher meant high tumble risk, and the standardized intervention measures were taken immediately. In 2013, the assessment scale was revised, and binocular vision disorder, low compliance or communication disorders, restlessness were added as risk factors for tumble. The difference among patients with a tumble score of 4 or higher between the year of 2012 and 2013 was compared and analyzed. Results In 2012, 52 patients had a tumble score of 4 or higher, among whom there were 16 males and 36 females; 35 were younger than 65 years old and 17 were older than 65 years. There were 25 patients with organic mental disorders, 10 with spirit obstacle caused by active substance, 12 with schizophrenia, and 5 other cases. In 2013, 154 patients' tumble score was 4 or higher, among whom there were 58 males and 96 females; 142 were younger than 65 years old and 12 were older than 65. Organic mental disorders occurred in 22 patients, 8 had spirit obstacle caused by active substance, 120 had schizophrenia, and there were 4 other cases. In 2013, the number of patients with a tumble score of 4 or higher were significantly more than that in 2012 and young patients with schizophrenia were also significantly more than in 2012 (P<0.05). There were two cases of tumble adverse events, while no adverse events occurred in tumble in 2013. Conclusion Cognitive impairment, low compliance, communication barriers and restlessness are high risk factors for tumble in patients with mental disorders. Correct evaluation and early intervention can effectively prevent the occurrence of tumble.

Citation： ZHANGZhuo-qiu, JIANGWei, ZUOXiao-feng. Assessment of Risk Factors and Early Intervention of Tumble in Patients with Mental Disorders. West China Medical Journal, 2015, 30(3): 527-530. doi: 10.7507/1002-0179.20150150 Copy

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1. 中華人民共和國衛生部. 醫院管理評價指南(試行)[J]. 中國護理管理, 2005, 5(2):5-12.
2. Kim EA, Mordiffi SZ, Bee WH. Evaluation of three fall-risk assessment tools in an acute care setting[J]. J Adv Nurs, 2007, 60(4):427-435.
3. 中國醫院協會. 患者安全目標手冊[M]. 北京:科學技術文獻出版社, 2008:108.
4. 中華人民共和國衛生部. 醫院管理評價指南(2008版)[EB/OL]. (2008-05-23)[2014-04-20]. http://www.moh.gov.cn/mohbgt/pw10807/200806/36242.shtml.
5. 江開達. 精神病學[M]. 2版. 北京:人民衛生出版社, 2005:115-315.
6. 陶筱琴, 陳恬茵. 精神病人跌倒危險因素評估及早期干預[J]. 國際護理學雜志, 2010, 29(6):804-806.
7. 蔣菊芳, 賈靜雯, 姚敏江, 等. 臨床護理路徑在精神分裂癥患者標準化管理中的應用[J]. 中華護理雜志, 2011, 46(10):970-973.
8. 施巧完, 趙水花. 護患雙方對跌倒預防的認知評價與對策[J]. 護理學報, 2011, 18(10A):60-62.
9. 鄧娟, 梁鳳珍, 黃新英, 等. 跌倒防護管理在精神分裂癥患者中的應用價值[J]. 國際護理雜志, 2014, 33(7):1843-1844.
10. 李素花, 周俊, 陳鴻, 等. 老年精神分裂癥患者跌倒危險因素[J]. 中國老年學雜志, 2014, 34(18):5256-5257.
11. 陶彩霞, 錢紅蕾. 預見性護理在住院精神分裂癥患者防跌倒中的應用[J]. 醫學前沿, 2013(32):61-62.
12. 傅慕君, 諸惠萍, 周莉莉, 等. 住院精神障礙患者跌倒致傷的情況分析[J]. 解放軍護理雜志, 2012, 29(6B):24-26.
13. 盛梅青, 房圓, 張盛宇, 等. 2003-2008年住院精神障礙患者跌倒損傷原因分析[J]. 上海醫藥, 2012, 33(1):33-36.
14. 陶筱琴, 端木欣榮, 陳恬茵, 等. 精神科病人跌倒危險評估及早期護理干預的方法與效果[J]. 護理管理雜志, 2011, 11(11):821-822.
15. 吳琳娜, 李蕓, 胡秀英, 等. 老年患者住院期間跌倒的危險因素分析及干預路徑[J]. 四川大學學報:醫學版, 2012, 43(2):222-225.
16. 王輝, 郭麗君, 莊利梅, 等. 住院患者跌倒墜床風險管理[J]. 護理學雜志, 2013, 28(18):69-70.
17. 余春, 李俊英, 湯暉. 實施優質護理服務對預防腫瘤患者跌倒的影響[J]. 華西醫學, 2012, 27(1):97-98.

West China Medical Journal

Assessment of Risk Factors and Early Intervention of Tumble in Patients with Mental Disorders

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