1 data and methods
1. 1 The general data of 50 patients with mental disorders from June 2065438 to June 2065438+February 2004 in the psychiatric inpatient department of Kangning Hospital in Jiangxi Province were selected as the research objects of the experimental group. From June 20 12 to June 20 12 in our hospital, 50 patients with mental disorders in psychiatric inpatient department were selected as the control group. All patients meet the diagnostic criteria of mental disorders in Oxford Psychiatry Textbook (5th edition, Chinese version) [3], and the course of disease is more than 6 months. Exclude those who are complicated with other diseases, those with language or physical disabilities, and those whose family members can't cooperate to complete the nursing task. There are 28 males and 22 females in the experimental group. The patients' age ranged from 23 to 665438 0 years with an average age of (32.65438 8.22) years. The course of the disease ranged from 6 months to 5 years, with an average age of (3.22 65438 0.08) years, including 28 cases of schizophrenia and 9 cases of depression. In the control group, there were 29 males and 265,438+0 females. The patients ranged in age from 24 to 60 years with an average age of (32.58 8.19) years. The course of the disease ranged from 6 months to 5 years, with an average age of (3.24 65,438+0.10) years, including 29 cases of schizophrenia. There is no significant difference in clinical data between the two groups, which is comparable.
1.2 Methods The control group was given routine nursing management. On this basis, the fall prevention nursing risk management was implemented for the patients in the experimental group: (1) Identify the current or potential fall risks of psychiatric inpatients, such as mutual play, impulsive behavior, fantasy or delusional behavior, wet toilet, postural hypotension, dizziness, etc. [4]. Assess the risk of patients falling every day, respond in time, and adjust the nursing plan. (2) Strengthen the health education for patients and their families to prevent falls, teach them basic knowledge such as related risk factors and hazards of accidental falls, improve their awareness of preventing falls, and master relevant prevention skills [5]. (3) Those who are in danger of impulsive falls can use nursing cuffs to protect and restrain the upper and lower limbs of patients in advance, and carry out protective isolation when necessary [6]. (4) Pay attention to keep the ground in the inpatient department dry to avoid patients entering. (5) Measure the blood pressure of patients in three positions: lying position, sitting position and standing position every day. Pay special attention to patients with postural hypotension and dizziness after getting up, and instruct patients to change their postures slowly. Generally, it is advisable to sit up for 30 s after waking up, stand up for 30 s after sitting up, and walk for 30 s after standing up [7]. (6) Strengthen the communication between nurses and patients, make good use of the situation and do a good job in psychological care.
Observation index 1.3 Compare the incidence and risk factors of falls between the two groups after implementing nursing management, and compare the illness and nursing satisfaction before and after implementing nursing management.
The brief mental scale (BPRS) [8] was used to evaluate the illness, and * * * included 18 questions, and the score of each question was 0: none; 1: suspicious; 2 points: mild; 3 points: medium; 4 points: biased; 5 points: severe score, with a total score of 90 points. The higher the score, the more serious the psychological disorder. The nursing satisfaction score was in the form of questionnaire. Patients and their families rated nursing service according to their subjective feelings, with the full score of 100. The higher the score, the higher the nursing satisfaction.
1.4 statistical method data were processed by statistical software SPSS 19.0, and the measurement data were expressed as "x s", and t test was used for comparison between groups. The number of count data cases (n) indicates that the ratio (%) between count data groups is compared by χ2 test; P < 0.05 was statistically significant.
Two results
2. 1 2 Comparison of the incidence and risk factors of falls in the experimental group * * Two cases (4.00%) fell after the implementation of nursing management, which was significantly lower than that in the control group (19 cases (38.00%), and the difference was statistically significant (P
2.2 Compare the BPRS score and nursing satisfaction score before and after the implementation of nursing management between the two groups. After the implementation of nursing management, the BPRS score of the experimental group was significantly lower than that of the control group, and the nursing satisfaction score was significantly higher than that of the control group, with statistical significance (P
3 discussion
Accidental falls can easily lead to bruises, bruises and soft tissue injuries, and even lead to fractures, subdural hemorrhage, head trauma and even death, which is the number one killer that seriously affects the life and quality of life of hospitalized patients [9]. The risk of accidental falls of psychiatric inpatients is higher than that of normal people, which needs more attention. Clinical research shows that psychiatric inpatients are prone to impulsive behavior, fantasy or delusional behavior due to mental symptoms, and long-term use of antipsychotics can also cause postural hypotension and dizziness. What are the main risk factors of falls in patients with mental disorders [10]. In view of the above situation, our hospital has drawn lessons from advanced nursing management experience at home and abroad, and formulated a set of practical nursing risk management scheme for preventing falls.
The results showed that the incidence of falls in the experimental group was significantly lower than that in the control group (P
In a word, the risk management of fall prevention nursing can effectively reduce the fall risk of psychiatric inpatients, reduce the incidence of falls, promote the improvement of patients' condition and improve nursing satisfaction, which has high clinical application value.
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