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Abstract：
OBJECTIVE: Undesirable events, such as falls, aspiration, and pressure ulcers, are associated with functional decline and lower quality of life among older adults. This study describes the frequency of such events among residents of geriatric care facilities and assesses the effect of training care managers in a multidisciplinary plan-do-check-adjust cycle on preventing such events.
METHODS: This was a Japan-based, non-randomized cluster intervention study. The intervention group comprised geriatric care facilities from which care managers had attended a training course, while the control group comprised facilities with care managers who did not receive this training. Six-month pre-admission and 3-month post-admission incidences of undesirable events were collected from both groups, and the two groups were compared.
RESULTS: Valid data were collected from 862 residents (416 and 446 from the intervention and control groups, respectively) from 130 facilities (60 and 70, respectively). Three-month post-admission incidences were 27.8%, 20.0%, and 11.3% for falls, fever, and pressure ulcers, respectively. There was no difference between the groups regarding post-admission incidence for any event type. Training care managers reduced the post-admission incidence of pressure ulcers among residents with a history of such ulcers.
CONCLUSIONS: The training of care managers in a multidisciplinary risk-management cycle was not effective for preventing falls, fever, or pressure ulcers. Results underscore the difficulty of preventing risk events in geriatric care facility residents even with organizational training efforts. The authors believe it is important to share such risks with residents and their families. Geriatr Gerontol Int 2021; 21: 842-848.
METHODS: This was a Japan-based, non-randomized cluster intervention study. The intervention group comprised geriatric care facilities from which care managers had attended a training course, while the control group comprised facilities with care managers who did not receive this training. Six-month pre-admission and 3-month post-admission incidences of undesirable events were collected from both groups, and the two groups were compared.
RESULTS: Valid data were collected from 862 residents (416 and 446 from the intervention and control groups, respectively) from 130 facilities (60 and 70, respectively). Three-month post-admission incidences were 27.8%, 20.0%, and 11.3% for falls, fever, and pressure ulcers, respectively. There was no difference between the groups regarding post-admission incidence for any event type. Training care managers reduced the post-admission incidence of pressure ulcers among residents with a history of such ulcers.
CONCLUSIONS: The training of care managers in a multidisciplinary risk-management cycle was not effective for preventing falls, fever, or pressure ulcers. Results underscore the difficulty of preventing risk events in geriatric care facility residents even with organizational training efforts. The authors believe it is important to share such risks with residents and their families. Geriatr Gerontol Int 2021; 21: 842-848.
摘要：
目标：不良事件，如瀑布，抽吸,和压疮,与老年人功能下降和生活质量下降有关。这项研究描述了老年护理机构居民中此类事件的发生频率，并评估了在多学科计划-检查-调整周期中培训护理管理人员对预防此类事件的影响。
方法：这是一个以日本为基地的，非随机整群干预研究。干预组包括老年护理机构，护理管理人员从这些机构参加了培训课程，而对照组包括没有接受这种培训的护理管理人员。收集两组患者入院前6个月和入院后3个月的不良事件发生率。并对两组进行比较。
结果：从862名居民中收集了有效数据（干预组和对照组的416和446，分别)来自130个设施(分别为60个和70个)。入院后三个月的发生率为27.8%，20.0%,下跌为11.3%，发烧,和压疮,分别。在任何事件类型的入院后发生率方面，两组之间没有差异。培训护理管理人员可降低有此类溃疡病史的居民的压疮入院后发生率。
结论：在多学科风险管理周期中对护理管理人员进行培训对于预防跌倒并不有效，发烧,或压疮。结果强调了即使通过组织培训工作，在老年护理机构居民中预防风险事件的难度。作者认为，与居民及其家人分担此类风险很重要。GeriatrGerontolInt2021；21：842-848。
方法：这是一个以日本为基地的，非随机整群干预研究。干预组包括老年护理机构，护理管理人员从这些机构参加了培训课程，而对照组包括没有接受这种培训的护理管理人员。收集两组患者入院前6个月和入院后3个月的不良事件发生率。并对两组进行比较。
结果：从862名居民中收集了有效数据（干预组和对照组的416和446，分别)来自130个设施(分别为60个和70个)。入院后三个月的发生率为27.8%，20.0%,下跌为11.3%，发烧,和压疮,分别。在任何事件类型的入院后发生率方面，两组之间没有差异。培训护理管理人员可降低有此类溃疡病史的居民的压疮入院后发生率。
结论：在多学科风险管理周期中对护理管理人员进行培训对于预防跌倒并不有效，发烧,或压疮。结果强调了即使通过组织培训工作，在老年护理机构居民中预防风险事件的难度。作者认为，与居民及其家人分担此类风险很重要。GeriatrGerontolInt2021；21：842-848。
