A volunteer companion-observer intervention reduces falls on an acute aged care ward.

Judith Donoghue, Jenny Graham, Suzanne Mitten-Lewis, Moira Murphy, Julie Gibbs
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引用次数: 51

Abstract

Purpose: Falls are the most frequently reported adverse event in hospitalised patients and carry a risk of great harm for the frail elderly. This intervention aimed to prevent high-risk in-patients on an acute aged care ward from falling.

Design/methodology/approach: Patients assessed at high falls risk were accommodated in a room staffed by volunteer companion-observers. The volunteers engaged them in conversation, played cards, opened meals and used the call bell to summon nurses if patients attempted to move from the bed or chair without assistance. Because of occupational health and safety considerations, the volunteers did not assist patients to ambulate.

Findings: The falls rate in the acute aged care ward decreased by 44 percent (p < 0.000). No patients fell in the observation room when volunteers were present. Relatives of participating in-patients expressed appreciation of the volunteer role, in terms of increased safety and also companionship. Volunteers exercised initiative in determining their pattern of work and developing resources to support their role.

Research limitations/implications: Because volunteers are not present around the clock, other strategies are needed to prevent wandering, frequently confused older in-patients from falling during the night.

Practical implications: In a context where frail elderly patients need constant supervision, using volunteers is a reasonable strategy.

Originality/value: This intervention used an inexpensive, human resources-based approach to significantly reduce the incidence of falls in the population at highest risk of falling. The additional benefits to patients in terms of cognitive improvement bear further investigation.

一个志愿者同伴-观察员干预减少跌倒在急性老年护理病房。
目的:跌倒是住院患者中最常见的不良事件,对体弱的老年人有很大的伤害风险。该干预措施旨在防止急性老年护理病房的高危住院患者摔倒。设计/方法/方法:评估为高跌倒风险的患者被安置在一个由志愿者陪同观察员组成的房间里。志愿者让他们与病人交谈、打牌、开餐,如果病人试图在没有帮助的情况下从床上或椅子上移动,他们就用呼叫铃叫护士。出于职业健康和安全考虑,志愿者不帮助病人走动。结果:急性老年护理病房的跌倒率下降了44% (p < 0.000)。当志愿者在场时,没有病人在观察室摔倒。参与治疗的住院病人的亲属对志愿者的作用表示赞赏,因为他们认为志愿者的作用增加了安全性,也增加了陪伴。志愿人员主动决定其工作方式和开发资源以支持其作用。研究限制/启示:由于志愿者不是24小时都在场,因此需要其他策略来防止徘徊,经常困惑的老年住院患者在夜间摔倒。实际意义:在体弱多病的老年患者需要持续监督的情况下,使用志愿者是一种合理的策略。独创性/价值:该干预措施采用了一种廉价的、以人力资源为基础的方法,显著降低了跌倒风险最高人群的跌倒发生率。在认知改善方面对患者的额外益处有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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