当院におけるリハビリテーション訓練時の急変・事故患者への対応について

Response to patients' unexpected changes and accidents during rehabilitation

要旨：当院(藤田保健衛生大学病院)のリハビリテーション訓練時における患者の容態の急変・事故発生時の対応システムを紹介した．当院では急変・事故発生時の対応を迅速かつ適切に行い，二次的な弊害を最小限にするため，対応の手順を体系化している．また再発防止対策として，担当療法士には原因や対応についてより深く考察し，医師・療法士管理職を含めたチームで情報を共有する目的で，報告書の作成を義務づけており，その情報はコンピュータにてデータベース化されている．今回は提出された急変・事故報告書を基に，当院における急変及び事故の発生状況，再発防止対策について後方視的に調査してまとめたので報告する．

　We investigated circumstances where unexpected changes and accidents occurred in patients during their rehabilitation training in our hospital, and how our rehabilitation staff responded to such emergency cases. This was to develop an adequate emergency response system and to prevent a similar occurrence.

　Unexpected changes occurred mostly in patients with a serious condition, and typically in the same patients. On the other hand, falling and tumbling accounted for 80% of all the accidents.

　The development of a systematic procedure to handle emergencies helped to avoid confusion and enabled a speedy and adequate response, minimizing secondary disabilities. As effective measures to avoid recurrence, therapists were encouraged to compile a report on each of the emergency cases so that they could identify the causes, reflect on their response, and also share information with managers and doctors. This prompted all of them to work as a team in exploring countermeasures in future emergency cases.