国际护理科学（英文）2023，Vol.10Issue(1)：30-37,后插2,9.
应用文本挖掘方法分析患者跌倒发生的方式和原因
Falls as the result of interplay between nurses,patient and the environment:Using text-mining to uncover how and why falls happen
摘要
Abstract
Objectives:This study aimed to explore,from the perspectives of nurses,how patients,the environment,and the practice of nurses interact with each other to contribute to patient falls.Methods:A retrospective review of incident reports on patient falls,registered by nurses between 2016 and 2020,was conducted.The incident reports were retrieved from the database set up for the project of the Japan Council for Quality Health Care.The text descriptions of the"background of falls"were extracted verbatim,and analyzed by using a text-mining approach.Results:A total of 4,176 incident reports on patient falls were analyzed.Of these falls,79.0％were unwitnessed by nurses,and 8.7％occurred during direct nursing care.Document clustering identified 16 clusters.Four clusters were related to patients,such as the decline in their physiological/cognitive function,a loss of balance,and their use of hypnotic and psychotropic agents.Three clusters were related to nurses,and these included a lack of situation awareness,reliance on patient families,and insufficient implementation of the nursing process.Six clusters were concerned with patients and nurses,including the unproductive use of a bed alarm and call bells,the use of inappropriate footwear,the problematic use of walking aids and bedrails,and insufficient understanding of patients'activities of daily living.One cluster,chair-related falls,involved both patient and environmental factors.Finally,two clusters involved patient,nurse,and environmental factors,and these falls occurred when patients were bathing/show-ering or using a bedside commode.Conclusions:Falls were caused by a dynamic interplay between patients,nurses,and the environment.Since many of the patient factors are difficult to modify in a short time,the focus has to be placed on nursing and environmental factors to reduce falls.In particular,improving nurses'situation awareness is of foremost importance,as it influences their decisions and actions to prevent falls.关键词
意外跌倒/数据挖掘/环境/跌倒风险/护士/病人Key words
Accidental falls/Data mining/Environment/Fall risk/Nurses/Patients引用本文复制引用
Miyuki Takase..应用文本挖掘方法分析患者跌倒发生的方式和原因[J].国际护理科学（英文）,2023,10(1):30-37,后插2,9.基金项目
This work was supported by Japan Society for the Promotion of Science(JSPS),Grants-in-Aid for Scientific Research[grant number 22K10749].The JSPS has had any roles in the survey's design,implementation,and analysis. （JSPS）
