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Psikiyatri Kliniğinde Çalışan Hemşirelerin Hasta Düşmeleri ve Önlenmesine İlişkin Bilgi ve Görüşleri

Year 2023, Volume: 16 Issue: 4, 487 - 501, 15.10.2023
https://doi.org/10.46483/jnef.1375527

Abstract

Giriş: Psikiyatri servislerinde hasta düşmeleri büyük bir güvenlik problemidir.

Amaç: Bu araştırma psikiyatri kliniklerinde çalışan hemşirelerin hasta düşmeleri ve önlenmesi ile ilgili bilgi ve görüşlerini belirlemek amacıyla yapılmıştır.

Yöntem: Çalışma tanımlayıcı tipte bir araştırmadır. Araştırma Haziran-Eylül 2017 tarihleri arasında İzmir’de iki üniversite hastanesi, iki eğitim ve araştırma hastanesi, bir devlet hastanesi ve bir Ruh Sağlığı ve Hastalıkları Hastanesi’nin psikiyatri kliniklerinde yapılmıştır. Araştırmanın örneklemini 80 hemşire oluşturmuştur. Veriler hemşirelerin hasta düşmeleri ve önlenmesine ilişkin bilgi ve görüşlerini değerlendirme formu ile toplanmıştır. Verilerin değerlendirilmesinde sayı-yüzde, ortalama ve standart sapma kullanılmıştır.

Bulgular: Psikiyatri kliniğinde çalışan hemşirelerin %97.5’i serviste hasta düşmeleriyle karşılaşmıştır. Hemşirelerin %85’i görülmeyen ve bildirilmeyen düşmelerin olabileceğini belirtmiştir. Hemşirelerin %88.8’i hasta düşmelerini önemli bir sorun olarak görmekte ve %87.5’ i düşmelerin önlenmesinde rolü olduğunu düşünmektedir. Hemşirelerin %57.5’ i hasta düşmeleri ve düşmeleri önleme ile ilgili eğitim almaya ihtiyaç duyduklarını belirtmişlerdir.

Sonuç: Psikiyatri kliniklerinde hemşirelerin bildirimlerine göre hasta düşmeleri oldukça fazla olmaktadır. Karşılaşılmayan ve görülmeyen hasta düşmelerinin hemşireler tarafından oldukça fazla olduğunun belirtilmesi bu birimlerde düşme riskinin değerlendirilmesi ve risk düzeyine göre koruyucu önlemlerin alınması gerektiğini göstermektedir. Psikiyatri kliniklerinde çalışan hemşirelere yönelik düşme riskini değerlendirme ve terapötik ortamda düşmeleri önlemeye yönelik önlemler konusunda önleyici programların oluşturulması ve uygulanması önerilir.

References

  • Abraham S. (2016). Factor contributing to psychiatric patient falls. J Community Med Health Educ, 6(2).
  • Ang E, Mordiffi SZ, Wong HB, Devi K, Evans D. (2007). Evaluation of three fall-risk assessment tools in an acute care setting. Journal of Advanced Nursing, 60(4),427-35.
  • An FR, Xiang YT, Lu JY, Lai KYC, Ungvari GS. (2009). Falls in a psychiatric institution in Beijing, China. Perspectives in Psychiatric Care, 45,183-90.
  • Barış VK, İntepeler ŞS, Yeginboy EY. (2016). İzmir ilinde bulunan üniversite ve kamu hastanelerindeki hasta düşmelerinin maliyet analizi. Uluslararası Sağlıkta Performans ve Kalite Kongresi Kongre Bilimsel Kitabı: 121- 32;Antalya.
  • Berke D, Aslan EF. (2010). Cerrahi hastalarını bekleyen bir risk: düşmeler, nedenleri ve önlemler. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 13(4),72-7.
  • Bloch F, Thibaud M, Dugue B, Breque C, Rigaud AS, Kemoun G. (2011). Psychotropic drugs and falls in the elderly people: updated literatüre review and meta-analysis. J Aging Health, 23(2), 329-46.
  • Bulut S, Türk G, Şahbaz M. (2013). Hemşirelerin hasta düşmelerini önlemeye yönelik uygulamalarının belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 16(3),163-69.
  • Cattelani L, Palumbo P, Palmerini L, Bandinelli S, Becker C, Chesani F et al. (2015). Frat-up, a fall-risk assessment tool for elderly people living in the community. J Med Internet Res, 17, 41-45.
  • Cascade E, Kalali AH, Kennedy SH. (2009). Real-world data on ssrı antidepressant side effects. psychiatry (Edgmont), 6(2):16-8.
  • Çapacı K. (2007). İnmede düşme ve kırıklar. Türk Fizik Tıp Rehabilitasyon Dergisi, 53(1): 7-10.
  • Çeçen D, Özbayır T. (2011). Cerrahi kliniklerinde yatan yaşlı hastalarda düşme riskinin belirlenmesi ve düşmeyi önlemeye yönelik yapılan girişimlerinin değerlendirilmesi. EÜHYO Dergisi, 27(1):11-23.
  • Çırpı F, Merih DY, Kocabey YM. (2009). Hasta güvenliğine yönelik hemşirelik uygulamaları ve hemşirelerin bu konudaki görüşlerinin belirlenmesi. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi, 2(3):26-34.
  • Deandrea S, Lucenteforte E, Bravi F, Foschi R, Vecchia CL and Negri E. (2010). Risk factors for falls in community-dwelling older people: A systematic review and meta-analysis. Epidemiology, 21(5):658-68.
  • De Carle AJ, Kohn R. (2001).Risk factors for falling in a psychogeriatric unit. International Journal of Geriatric Psychiatry, 16:762-7.
  • Duman S, Kitiş Y. (2013). Yoğun bakımda çalışan hemşirelerin hasta düşmeleri ile ilgili farkındalıklarının belirlenmesi. Türk Yoğun Bakım Derneği Dergisi, 11:72-9.
  • Estrin I, Goetz R, Hellerstrein DJ, Bennet- Staub A, Seirmarco G. (2009). Predicting falls among psychiatric patients: A case- control study at a state psychiatric facility. Psychiatric Services, 60:1245-1250.
  • Ganabathi M, Mariappan U, Mustafa H. (2017). Nurses’ knowledge, attitude and practices on fall prevention in King Abdul Aziz Hospital, Kingdom of Saudi Arabia. Int J Nur Care, 1(5):1-6.
  • Resmi Gazete, Hasta ve Çalışan Güvenliğinin Sağlanmasına Yönelik Yönetmelik, 6 Nisan 2011-Sayı:27897.
  • Işık A, Cankurtaran M, Doruk H, Mas MR. (2006). Geriatrik olgularda düşmelerin değerlendirilmesi. Turkish Journal of Geriatrics, 9(1):45-50.
  • Joint Commission International Accreditadion Standard for Hospital. Joint Commission Resource, Updated International Patient Safety Goals Text Now, on JCI Web Site, 2014, http://tr.jointcommissioninternational.org. (Erişim tarihi: 08.09.2022)
  • Knight M, Coakley C. (2010). Fall risk in patients with acute psychosis. J Nurs Care Qual, 25:208-15.
  • Koh SSL, Manias E, Hutchinson AM, Donath S, Johnston L. (2008). Nurses’ perceived barriers to the implementation of a fall prevention clinical practice guidelines in Singapore hospitals. BMC Health Service Research, 8(1):105.
  • Lee A, Mills PD, Wats BV. (2012). Using root cause analysis to reduce falls with injury in the psychiatric unit. General Hospital Psychiatry, 34(3):304-11.
  • Lavsa SM, Fabian TJ, Saul MI, Corman SL, Coley KC. (2010). Influence of medications and diagnoses on fall risk in psychiatric inpatients. American Journal of Health System Pharmacy, 67:1274-80.
  • Logan PA, Coupland CAC, Gladman JRF, Sahota O, Ward M, Sach T et al. (2010). Community falls prevention for people who call an emergency ambulance after a fall: randomised controlled trial. BMJ, 340:2102.
  • Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review. Ann Intern Med, 158(5): 390-96.
  • Morse JM. Preventing patient falls. Second Edition. New York. Springer Publishing Company. 2009;53-9.
  • Myers H. Hospital fall risk assessment tools: a critique of the literature. (2003). International Journal of Nursing Practice, 9:223-35.
  • Oliver D, Connelly JB, Victor CR, Shaw FE, Whitehead A, Genc Y et al. (2007). Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: A systematic review and meta-analyses. British Medical Journal, 334(7584):82-86.
  • Oliver D, Healey F, Haines TP. (2010). Preventing falls and fall-related injuries in hospitals. Clin Geriatr Med, 26(4):645-692.
  • Pepin R, Segal DL, Coolidge FL. (2009). Intrinsic and extrinsic barriers to mental health care among community-dwelling younger and older adults. Aging Ment Health, 13:769-777.
  • Saccomano S, Ferrara L. (2015). Fall prevention in older adults. Nurse Pract, 40(6):40-47,11.
  • Scanlan J, Wheatley J, McIntosh S. (2012). Characteristics of falls in inpatient psychiatric units. Australas Psychiatry, 20:305-8.
  • Scheffer AC, Schuurmans MJ, Dijk NV, Hooft TVD, Rooij AED. (2008). Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1):19-24.
  • Spoelstra SL, Given BA, Given CW. (2012). Fall prevention in hospitals: an integrative rewiew. Clin Nurs Res, 21(1):92-112.
  • Stalhandske E, Quigley P, Neily J, Bagian J. VHA’s natioanl falls collaborative and prevention programs. In Advances in patient safety: New directions and alternative approaches. In Rockville, MD: Agency for Healthcare Research and Quality: Vol. 2. Culture and Redesign. 2008 (pp.393-407).
  • Stubbs B. (2011). Fall in older adult psychiatric patients: equipping nurses with knowledge to make a difference. J Psychiatr Ment Health Nurs, 18:457-62.
  • Tay Sim-Yeng C, Queck C, Pariayasami S, Ong B C, Wee B C, Yeo J L et al. (2000). Fall incidence in a state psychiatric hospital in Singapore. Journal of Psychosocial Nursing and Mental Health Services, 38:10-16.

Information And Opinions of Psychiatric Nurses on Patient Falling Down and Prevention

Year 2023, Volume: 16 Issue: 4, 487 - 501, 15.10.2023
https://doi.org/10.46483/jnef.1375527

Abstract

Background: Falls in psychiatric wards have been a big safety problem.

Objective: This study was carried out to determine the knowledge and opinions of nurses working in adult psychiatric clinics about the patient falls and prevention.

Methods: This study was descriptive. The research was carried out at two university hospitals, two education and research hospitals, one public hospital and one mental health and psychiatric hospital in İzmir province in June- September 2017. The sample of the study consisted of 80 nurses. Data collection was created in the literature of nurses in accordance with the information and opinions regarding the evaluation form and preventing patient falls were used. Number and percentage distributions, mean and standard deviation analysis were used in the evaluation of the data.

Results: 97.5% of the nurses working in the psychiatric wards have experienced falling of patients. 85% of the nurses stated that there may be unobserved and undeclared falls. 88.8% of the nurses consider the patient falls as an important problem and 87.5% think that they have a role in preventing falls. 57.5% of the nurses stated that they needed training on falling and preventing falls.

Conclusion: According to the experience of nurses in psychiatric clinics, patient falls are considerable. The fact that nurses have a high rate of unexplained and unrecognized patient falls indicates that the risk of falling should be assessed and protective measures should be taken according to the risk level. It is recommended that preventive programs, such as assessing the risk of falling for nurses working in psychiatric clinics, taking precautions to prevent falls in the therapeutic environment, are implemented.

References

  • Abraham S. (2016). Factor contributing to psychiatric patient falls. J Community Med Health Educ, 6(2).
  • Ang E, Mordiffi SZ, Wong HB, Devi K, Evans D. (2007). Evaluation of three fall-risk assessment tools in an acute care setting. Journal of Advanced Nursing, 60(4),427-35.
  • An FR, Xiang YT, Lu JY, Lai KYC, Ungvari GS. (2009). Falls in a psychiatric institution in Beijing, China. Perspectives in Psychiatric Care, 45,183-90.
  • Barış VK, İntepeler ŞS, Yeginboy EY. (2016). İzmir ilinde bulunan üniversite ve kamu hastanelerindeki hasta düşmelerinin maliyet analizi. Uluslararası Sağlıkta Performans ve Kalite Kongresi Kongre Bilimsel Kitabı: 121- 32;Antalya.
  • Berke D, Aslan EF. (2010). Cerrahi hastalarını bekleyen bir risk: düşmeler, nedenleri ve önlemler. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 13(4),72-7.
  • Bloch F, Thibaud M, Dugue B, Breque C, Rigaud AS, Kemoun G. (2011). Psychotropic drugs and falls in the elderly people: updated literatüre review and meta-analysis. J Aging Health, 23(2), 329-46.
  • Bulut S, Türk G, Şahbaz M. (2013). Hemşirelerin hasta düşmelerini önlemeye yönelik uygulamalarının belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 16(3),163-69.
  • Cattelani L, Palumbo P, Palmerini L, Bandinelli S, Becker C, Chesani F et al. (2015). Frat-up, a fall-risk assessment tool for elderly people living in the community. J Med Internet Res, 17, 41-45.
  • Cascade E, Kalali AH, Kennedy SH. (2009). Real-world data on ssrı antidepressant side effects. psychiatry (Edgmont), 6(2):16-8.
  • Çapacı K. (2007). İnmede düşme ve kırıklar. Türk Fizik Tıp Rehabilitasyon Dergisi, 53(1): 7-10.
  • Çeçen D, Özbayır T. (2011). Cerrahi kliniklerinde yatan yaşlı hastalarda düşme riskinin belirlenmesi ve düşmeyi önlemeye yönelik yapılan girişimlerinin değerlendirilmesi. EÜHYO Dergisi, 27(1):11-23.
  • Çırpı F, Merih DY, Kocabey YM. (2009). Hasta güvenliğine yönelik hemşirelik uygulamaları ve hemşirelerin bu konudaki görüşlerinin belirlenmesi. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi, 2(3):26-34.
  • Deandrea S, Lucenteforte E, Bravi F, Foschi R, Vecchia CL and Negri E. (2010). Risk factors for falls in community-dwelling older people: A systematic review and meta-analysis. Epidemiology, 21(5):658-68.
  • De Carle AJ, Kohn R. (2001).Risk factors for falling in a psychogeriatric unit. International Journal of Geriatric Psychiatry, 16:762-7.
  • Duman S, Kitiş Y. (2013). Yoğun bakımda çalışan hemşirelerin hasta düşmeleri ile ilgili farkındalıklarının belirlenmesi. Türk Yoğun Bakım Derneği Dergisi, 11:72-9.
  • Estrin I, Goetz R, Hellerstrein DJ, Bennet- Staub A, Seirmarco G. (2009). Predicting falls among psychiatric patients: A case- control study at a state psychiatric facility. Psychiatric Services, 60:1245-1250.
  • Ganabathi M, Mariappan U, Mustafa H. (2017). Nurses’ knowledge, attitude and practices on fall prevention in King Abdul Aziz Hospital, Kingdom of Saudi Arabia. Int J Nur Care, 1(5):1-6.
  • Resmi Gazete, Hasta ve Çalışan Güvenliğinin Sağlanmasına Yönelik Yönetmelik, 6 Nisan 2011-Sayı:27897.
  • Işık A, Cankurtaran M, Doruk H, Mas MR. (2006). Geriatrik olgularda düşmelerin değerlendirilmesi. Turkish Journal of Geriatrics, 9(1):45-50.
  • Joint Commission International Accreditadion Standard for Hospital. Joint Commission Resource, Updated International Patient Safety Goals Text Now, on JCI Web Site, 2014, http://tr.jointcommissioninternational.org. (Erişim tarihi: 08.09.2022)
  • Knight M, Coakley C. (2010). Fall risk in patients with acute psychosis. J Nurs Care Qual, 25:208-15.
  • Koh SSL, Manias E, Hutchinson AM, Donath S, Johnston L. (2008). Nurses’ perceived barriers to the implementation of a fall prevention clinical practice guidelines in Singapore hospitals. BMC Health Service Research, 8(1):105.
  • Lee A, Mills PD, Wats BV. (2012). Using root cause analysis to reduce falls with injury in the psychiatric unit. General Hospital Psychiatry, 34(3):304-11.
  • Lavsa SM, Fabian TJ, Saul MI, Corman SL, Coley KC. (2010). Influence of medications and diagnoses on fall risk in psychiatric inpatients. American Journal of Health System Pharmacy, 67:1274-80.
  • Logan PA, Coupland CAC, Gladman JRF, Sahota O, Ward M, Sach T et al. (2010). Community falls prevention for people who call an emergency ambulance after a fall: randomised controlled trial. BMJ, 340:2102.
  • Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review. Ann Intern Med, 158(5): 390-96.
  • Morse JM. Preventing patient falls. Second Edition. New York. Springer Publishing Company. 2009;53-9.
  • Myers H. Hospital fall risk assessment tools: a critique of the literature. (2003). International Journal of Nursing Practice, 9:223-35.
  • Oliver D, Connelly JB, Victor CR, Shaw FE, Whitehead A, Genc Y et al. (2007). Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: A systematic review and meta-analyses. British Medical Journal, 334(7584):82-86.
  • Oliver D, Healey F, Haines TP. (2010). Preventing falls and fall-related injuries in hospitals. Clin Geriatr Med, 26(4):645-692.
  • Pepin R, Segal DL, Coolidge FL. (2009). Intrinsic and extrinsic barriers to mental health care among community-dwelling younger and older adults. Aging Ment Health, 13:769-777.
  • Saccomano S, Ferrara L. (2015). Fall prevention in older adults. Nurse Pract, 40(6):40-47,11.
  • Scanlan J, Wheatley J, McIntosh S. (2012). Characteristics of falls in inpatient psychiatric units. Australas Psychiatry, 20:305-8.
  • Scheffer AC, Schuurmans MJ, Dijk NV, Hooft TVD, Rooij AED. (2008). Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1):19-24.
  • Spoelstra SL, Given BA, Given CW. (2012). Fall prevention in hospitals: an integrative rewiew. Clin Nurs Res, 21(1):92-112.
  • Stalhandske E, Quigley P, Neily J, Bagian J. VHA’s natioanl falls collaborative and prevention programs. In Advances in patient safety: New directions and alternative approaches. In Rockville, MD: Agency for Healthcare Research and Quality: Vol. 2. Culture and Redesign. 2008 (pp.393-407).
  • Stubbs B. (2011). Fall in older adult psychiatric patients: equipping nurses with knowledge to make a difference. J Psychiatr Ment Health Nurs, 18:457-62.
  • Tay Sim-Yeng C, Queck C, Pariayasami S, Ong B C, Wee B C, Yeo J L et al. (2000). Fall incidence in a state psychiatric hospital in Singapore. Journal of Psychosocial Nursing and Mental Health Services, 38:10-16.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Nursing (Other)
Journal Section Research Articles
Authors

Elif Şen 0000-0002-4882-5728

Zekiye Çetinkaya Duman 0000-0002-7447-874X

Early Pub Date October 15, 2023
Publication Date October 15, 2023
Published in Issue Year 2023 Volume: 16 Issue: 4

Cite

APA Şen, E., & Çetinkaya Duman, Z. (2023). Psikiyatri Kliniğinde Çalışan Hemşirelerin Hasta Düşmeleri ve Önlenmesine İlişkin Bilgi ve Görüşleri. Etkili Hemşirelik Dergisi, 16(4), 487-501. https://doi.org/10.46483/jnef.1375527

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