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

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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. 中华人民共和国卫生部. 医院管理评价指南(试行)[J]. 中国护理管理, 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. 中国医院协会. 患者安全目标手册[M]. 北京:科学技术文献出版社, 2008:108.
4. 中华人民共和国卫生部. 医院管理评价指南(2008版)[EB/OL]. (2008-05-23)[2014-04-20]. http://www.moh.gov.cn/mohbgt/pw10807/200806/36242.shtml.
5. 江开达. 精神病学[M]. 2版. 北京:人民卫生出版社, 2005:115-315.
6. 陶筱琴, 陈恬茵. 精神病人跌倒危险因素评估及早期干预[J]. 国际护理学杂志, 2010, 29(6):804-806.
7. 蒋菊芳, 贾静雯, 姚敏江, 等. 临床护理路径在精神分裂症患者标准化管理中的应用[J]. 中华护理杂志, 2011, 46(10):970-973.
8. 施巧完, 赵水花. 护患双方对跌倒预防的认知评价与对策[J]. 护理学报, 2011, 18(10A):60-62.
9. 邓娟, 梁凤珍, 黄新英, 等. 跌倒防护管理在精神分裂症患者中的应用价值[J]. 国际护理杂志, 2014, 33(7):1843-1844.
10. 李素花, 周俊, 陈鸿, 等. 老年精神分裂症患者跌倒危险因素[J]. 中国老年学杂志, 2014, 34(18):5256-5257.
11. 陶彩霞, 钱红蕾. 预见性护理在住院精神分裂症患者防跌倒中的应用[J]. 医学前沿, 2013(32):61-62.
12. 傅慕君, 诸惠萍, 周莉莉, 等. 住院精神障碍患者跌倒致伤的情况分析[J]. 解放军护理杂志, 2012, 29(6B):24-26.
13. 盛梅青, 房圆, 张盛宇, 等. 2003-2008年住院精神障碍患者跌倒损伤原因分析[J]. 上海医药, 2012, 33(1):33-36.
14. 陶筱琴, 端木欣荣, 陈恬茵, 等. 精神科病人跌倒危险评估及早期护理干预的方法与效果[J]. 护理管理杂志, 2011, 11(11):821-822.
15. 吴琳娜, 李芸, 胡秀英, 等. 老年患者住院期间跌倒的危险因素分析及干预路径[J]. 四川大学学报:医学版, 2012, 43(2):222-225.
16. 王辉, 郭丽君, 庄利梅, 等. 住院患者跌倒坠床风险管理[J]. 护理学杂志, 2013, 28(18):69-70.
17. 余春, 李俊英, 汤晖. 实施优质护理服务对预防肿瘤患者跌倒的影响[J]. 华西医学, 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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