Application Of Total Quality Management Mode In Preventing Fall Of Elderly Patients

Objective:To analyze the impact of total quality management model on the perception,attitude and behavior of hospitalized elderly patients,nursing staff and caregivers to prevent falls,and explore the impact of total quality management model on reducing the incidence of falls and the degree of fall injury in elderly hospitalized patients.Method:Taking a top three hospitals in Guangzhou as a test point,the role of total quality management mode in the prevention of falls in hospitalized elderly patients was studied.The study consists of three parts:1.Review of basic data of 93 inpatients with falling in 2017:Analysis of the basic situation of all 93 patients who fell in the trial hospital in 2017,study the general sociological data,fall related data,fall related Factors and the causes of the fall.Statistics and analysis were performed using the composition comparison data.2.Investigation on the status of anti-fall knowledge of hospitalized patients,nursing staff and caregivers:A cross-sectional survey was conducted.In January 2018,135 inpatients aged over 65 years were randomly selected,and 90 nurses and 135caregivers were taken during the same period.To understand the factors that have caused the fall to occur.The results of the survey data were compiled using Excel 2016 and described and analyzed.3.The application of the total quality management model in preventing the fall of elderly hospitalized patients:for the fall-related factors,the overall quality management model is adopted for the whole process,and all members participate in the fall prevention management.Chi-square test was used to compare the awareness rate of anti-fall knowledge among nursing staff,hospitalized patients and caregivers before and after intervention.Systematic evaluation of the overall quality management model to reduce the incidence of falls and the extent of damage.Result:(1)Among the 93 patients who fell in 2017,the fall score was significantly correlated with age(r=0.225,P=0.03).According to the analysis of adverse event reports,the main four causes of the fall event were:nurses lack of anti-fall knowledge,poor patient compliance,inadequate management of accompanying care,and difficulty in identifying drugs that are easy to fall.The high-risk departments in which falls occurred were:rehabilitation medicine,cardiovascular medicine,nephrology,endocrinology,neurology,Chinese medicine,respiratory medicine,and dry protection.The cumulative percentage of falls in the above eight departments exceeded 80%of the total incidence.The maximum time period for a fall is 0:00-8:00.(2)In January 2018,a comprehensive survey of the fall prevention knowledge of patients,nursing staff,and caregivers revealed that the main factors for the prevention of falls in patients and nursing staff were:patients were not aware of the use of fall-fighting drugs(96.3%,130)/135);inadequate implementation of anti-fall measures for nursing staff(97.78%,88/90);(3)The baseline data of hospitalized patients in 2017 and 2018 were compared,and the difference was not statistically significant.From January to December 2018,the comprehensive quality management model was adopted to conduct a comprehensive,full-process,full-partial fall prevention management for the main cause of the fall.Comparing the awareness rate of anti-fall knowledge between patients,nursing staff and caregivers,the results showed that after the intervention,the knowledge of fall knowledge increased significantly(?~2=30.00,P<0.001),rising from 33.33%(45/135)to 66.67%(90/135);the awareness rate of anti-fall knowledge of nursing staff increased from 73.33%(66/90)before intervention to 86.67%(78/90),with significant difference(?~2=5,P<0.05)After intervention,the awareness rate of anti-fall knowledge of caregivers increased from 36.3%(49/135)to 50.4%(68/135),with significant difference(?~2=5.45,P<0.05).In 2018,the fall rate of hospitalized patients was significantly lower than that of 2017(?~2=9.22,P<0.01),from 0.35‰(93/277207)before intervention to 0.20‰(56/277423);There was a significant difference in the distribution of different degrees of injury before and after intervention(?~2=57.73,P<0.001).Conclusion:(1)In addition to the type of disease and the age of the patient,the fall of the elderly inpatient is mainly related to the lack of knowledge of the fall prevention of patients,caregivers and caregivers.(2)The overall quality management model effectively improves the cognitive level of fall prevention knowledge among patients,caregivers and caregivers.In the total quality management mode,the fall rate of hospitalized elderly patients decreased significantly,and the degree of fall injury was significantly reduced.