Application of root cause analysis and actions combined with strengthening exercise of knee joint control in fall management of elderly patients
10.3760/cma.j.issn.1674-2907.2019.19.014
- VernacularTitle:根本原因分析及行动结合膝关节控制的强化训练在老年患者跌倒管理中的应用
- Author:
Yuehua XU
1
;
Jun LU
;
Amao TANG
;
Tianxiao CHEN
;
Yulin HE
Author Information
1. 杭州市第一人民医院康复科 310006
- Keywords:
Aged;
Fall;
Root cause analysis;
Intensive training of knee joint control
- From:
Chinese Journal of Modern Nursing
2019;25(19):2435-2439
- CountryChina
- Language:Chinese
-
Abstract:
Objective? To analyze the root causes of fall in elderly patients, explore the corresponding countermeasures and combine the balance function and knee joint strengthening training to reduce the incidence of fall in elderly patients. Methods? First, the cause of fall of the patients in the department of rehabilitation from November 2014 to October 2016 were analyzed with the method of root cause analysis and retrospective analysis, and targeted corrective measures were formulated. The elderly patients fell between the time period from November of 2016 to October of 2017 and November of 2017 to October of 2018 were enrolled into the control group and observation group by convenience sampling. Corrective measures were formulated based on root cause analysis and action (RCA2) to prevent falls in the control group, on the basis of that balance function training combined with strengthening training of knee joint control were adopted to prevent fall in the observation group. The two groups were compared in terms of the differences in the incidence of fall, five times of sitting and standing test(FTSST), 10 meters maximum walking speed (10MWS), Berg Balance Scale(BBS)and Tinetti Gait Analysis (TGA). The incidence of fall in the department before the implementation of corrective measures based on RCA2(November 2014 to October 2016) and the time period of November 2016 to October 2018 which is after the implementation of RCA2 based corrective measures were compared. Results? After implementing the corrective measures, the fall rate of the elderly patients reduced from 2.0% to 0.9% with statistical difference (χ2=4.343, P=0.037). There was statistical difference (χ2=3.899, P=0.048) in terms of the incidence of fall between the observation group (4.24%) and the control group (0.64%). Before intervention, the two groups had no statistical difference in the FTSST, 10MWS, BBS and TGA(P＞0.05). In the control group, there was no statistical difference before and after intervention (P＞ 0.05); in the observation group, there was statistical difference before and after intervention (P＜0.05). After intervention, the observation group was better than the control group in the FTSST, 10MWS, BBS and TGA with statistical difference (P＜0.05). Conclusions? The comprehensive use of root cause analysis and intensive training of knee joint control and balance function training to manage elderly patients scientifically can effectively reduce the incidence of falls.
