介護老人保健施設における転倒防止に関する連携の形とその効果

The framework and the effects of collaboration on fall prevention in nursing homes

要旨：保健医療福祉において連携によるサービスの提供は，もはや時代のニーズとなった．一方で，臨床現場では何に対してどう連携すればよいのかといった試行錯誤も伺える．本研究では，連携の形とその効果を介護老人保健施設における転倒防止の取り組みを切り口に全国調査を行った．結果は，転倒防止に対してフォーマル・インフォーマル双方が相互作用しあった連携による取り組みが行われている施設では，より有効な転倒防止策が実践されていた．介護老人保健施設における転倒防止に関する連携には，多職種が積極的に参画しあい目的を転倒防止に絞った組織的な構造が必要となることが示唆された．

　In today's field of health and welfare, collaborative services have become necessary. Trial-and-error research into collaboration should be conducted to improve clinical environments.

　This study examines how nursing home personnel deal with fall prevention, and how different departments, in many parts of Japan, collaborate in the effort to establish the most effective means by which falling can be prevented. This has resulted in professionals, from diverse medical backgrounds, interacting with other professionals who possess the most fall prevention awareness. Those nursing homes with the most effective collaboration have, as a result, developed the most effective fall prevention approaches.

　Health care committees should be established in order to narrow down systematic structures with regard to fall prevention, and should further develop collaborative measures, which will further aid in fall prevention on a national level. This could lead to more effective assessments of fall risk factors, thus increasing awareness as to which patients are the most "at risk", which, in turn, would lead to more discoveries in fall prevention, in general. Furthermore, and most importantly, staff members, patients, and family members should be made aware, through education, of these prevention approaches. With these continuing efforts to educate everyone concerned, not only will better fall prevention grow, but new systems regarding teamwork and collaboration will grow naturally.