Construction And Application Of The Intervention Strategy Based On The Patient Engagement Framework For The Prevention Of Falls In Elderly Inpatients

Objective1.To construct the "Intervention strategy for elderly inpatients participation in falls prevention" based on the "Patients Engagement Framework".2.To explore the influence of "Intervention strategy for elderly inpatients participation in falls prevention" on the level of knowledge,attitude and practice,the level of fall efficacy and the incidence of falls,so as to provide a reference for hospital managers to improve the safety management strategy of fall prevention.Methods1.The construction stage of "Intervention strategy for elderly inpatients participation in falls prevention"(1)Through cross-cultural revision,Delphi method and pilot test,the "i Engaging fall self-assessment scale" was translated and revised.(2)Through literature review,focus group discussion and pilot test,the "Intervention strategy for elderly inpatients participation in falls prevention" was determined based on the five parts of the "Patient Engagement Framework".2.The application stage of "Intervention strategy for elderly inpatients participation in falls prevention"(1)According to the experimental research method,the neurology department,geriatrics department,oncology department and cardiology department of a Grade III Level A hospital in Hubei Province were selected as the research sites,59 elderly inpatients who met the inclusion criteria from January to June 2019 were selected as the control group,and routine fall prevention measures were taken;Another 59 elderly inpatients who met the inclusion criteria from July to December 2019 were selected as the experimental group,and "Intervention strategy for elderly inpatients participation in falls prevention" were taken.(2)Through a questionnaire survey,we compared the changes in knowledge,attitude,practice level,fall efficacy level and fall incidence of the elderly inpatients in the two groups before and after the intervention.(3)Through mathematical statistics,Excel 2016 and SPSS 21.0 software were used for data entry,sorting and statistical analysis;mean,standard deviation and percentage were used for descriptive analysis;The t test,Chi-square test and Fisher’s exact probability method were used to analyze the balance test and difference test of the evaluation indexes of the two groups of patients before and after intervention.Results1.Construction of "Intervention strategy for elderly inpatients participation in falls prevention"(1)After translation and revision,the Chinese version of "i Engaging fall self-assessment scale" was obtained,which included 13 dimensions and 59 items,with a reliability coefficient of 0.83 and a content validity index of 0.98.It had good reliability and validity.The overall content was easy to understand and answer.It was determined to be an autonomous fall risk assessment tool for intervention strategies.(2)The "intervention strategy for elderly inpatients to participate in falls prevention" was determined,including the following contents:(1)Informing stage:informing the patients of the purpose and content of the study,obtaining informed consent and cooperation;(2)Participation stage: the patients independently assessed the risk of falls,and the system automatically generated the assessment results;(3)Empowerment stage: the nurses and patients jointly analyzed the assessment results,and discussed and determined the personalized nursing plan;(4)Cooperation stage:nurses and patients participated in multiple forms of intervention process,in order tostrengthen understanding and memory;(5)Electronic information support: relevant scales and questionnaires were imported into the hospital electronic system and uploaded automatically,and results were generated.2.Application of "Intervention strategy for elderly inpatients participation in falls prevention"(1)Comparison of the scores of knowledge,belief and behavior scale of elderly inpatients participating in falls preventionAfter the intervention strategy was carried out,the scores of all dimensions of the scale on knowledge,attitude and practice of participating in fall prevention in the experimental group were higher than those in the control group,and the difference between the two groups was statistically significant(P < 0.05).(2)Comparison of the scores of the revised fall effect scaleAfter the intervention strategy was carried out,the scores of the fall efficacy scale were compared between the two groups.The scores of the patients in the experimental group were higher than those in the control group.The difference between the two groups was statistically significant(P < 0.05).(3)Comparison of fall incidenceAfter the intervention strategy was carried out,the number of falls in the experimental group was lower than that in the control group.Conclusion1.This study introduced and sinicize the "i Engaging fall self-assessment scale" to enable patients to participate in the fall risk assessment process independently,promoted their awareness and understanding of their own fall risk,and provided accurate information for making effective fall prevention plans.2.This study used scientific research methods to build a reasonable and feasible "Intervention strategy for elderly inpatients participation in falls prevention" based on the "Patients Engagement Framework",which can achieve the fullparticipation of patients in the process of "assessment-plan-implementation-evaluation" to prevent falls.3.The application of "Intervention strategy for elderly inpatients participation in falls prevention" improved the awareness of self prevention of falls in elderly inpatients effectively,improved the level of knowledge,attitude and practice of patients to participate in the prevention of falls,and the level of fall efficacy,and reduced the number of falls,which provided reference for the establishment of safety management strategies for elderly inpatients to participate in the prevention of falls in line with the clinical practice in China.