| Objectives:To construct a patient safety project tool with Chinese characteristics,and to explore the feasibility of this tool in the geriatric ward by qualitative research.Furthermore,to explore the effect of this tool to prevent the fall of elderly patients and promote the safety of patients in the ward.Methods:1.The Comprehensive Unit-based Safety Program(CUSP)toolkit was translated and evaluated by stratified translation,correction and validity verification.The focus group interview method was conducted with the staff involved in the prevention of fall prevention program in the ward,and the data were sorted and analyzed by using Colaizzi's seven-step analysis method.2.The study subjects were selected from July to August 2017 and from November to December 2017 in the elderly patients with cardiovascular disease in a tertiary hospital in Shandong province.Convenience sampling and grouping were conducted according to the order of admission.Finally,64 cases of elderly patients were treated as control group before intervention,and 64 elderly patients were treated as intervention group.The control group used the old version falls prevention program,including routine assessment,oral education and so on.The intervention group implemented a new version of the fall prevention program that met the characteristics of the geriatric wards,include fall risk factors assessment,identification of orthostatic hypotension,individualized fall prevention tips,propaganda video of fall prevention and feedback form of fall prevention knowledge,etc.During the patient's hospital stay,two groups of patients were collected,questionnaires were carried out and records of falls were recorded.SPSS 22.0 software were used for data entry and analysis.Results:1.There themes were classified including the advantages of the comprehensive unit-based safety program(CUSP),the disadvantages of the comprehensive unit-based safety program(CUSP)and the suggestions of the comprehensive unit-based safety program(CUSP).2.There were 3(4.7%)fall cases in the control group and 1(1.6%)fall case in the intervention group.The results of Fisher's exact test showed that no statistically significant difference in the two groups(P = 0.169).3.The fall efficacy was compared in the two groups.The intervention group scored higher than the control group in changing clothes,bathing,sitting up in a chair,answering the door or the phone,and walking around the room.There was significant difference between the two groups(P<0.05).4.The risk assessment results were compared between the two groups,and there was no difference between the intervention group and the control group in the risk of falls.And there was no statistical significance(P>0.05).5.Compared the intervention group with the control group,the score of knowledge dimension of fall prevention was increased from 31(5)to 41(6).The score of attitude dimension was improved from 24(6)to 33(3).The score of the behavior dimension was enhanced from 45(7)to 50(2).And the total score 99.50(13.25)was increased to 123.50(13.25).The score of each dimension and total score were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusions:1.Based on stratified translation,correction and validity verification,this paper constructed a localized CUSP model to guide patient safety practice.The feasibility of the CUSP model after across-culture adjustment was discussed by qualitative interview,which proved that it was scientific and reproducible,and could be widely used.2.We formulated the fall prevention program that conforms to the characteristics of the geriatric wards through the application of CUSP model.It is proved that this intervention could effectively improve the level of the patient's knowledge,attitude and practice of fall prevention.The patients' willingness to participate in the fall prevention were promoted,and beneficial behaviors were taken initiatively. |
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