针对性综合对策干预用于肿瘤病区护理可降低不良事件发生率
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摘要
为了探讨肿瘤病区护理不良事件及其干预对策,本研究通过收集2016年1～12月我院肿瘤病区护理不良事件发生情况,制定针对性对策进行干预,观察干预后护理不良事件发生情况。本研究结果显示,2016年1～12月我院肿瘤病区上报护理不良事件59起,主要以意外拔管、医嘱处理错误和药物外渗为主,分别占38.98%、23.73%和16.95%;护理不良事件分级:0级共0起、Ⅰ级27起、Ⅱ级25起、Ⅲ级6起、Ⅳ级1起和Ⅴ级0起;护理工作年限<5年者中发生护理不良事件比例为33.33%,明显高于工作年限≥5年者(p<0.05);护士职称者中发生护理不良事件比例为30.88%,明显高于护师及以上职称者(p<0.05);护理不良事件时间分布中,13:00～18:00护理不良事件比例最高,达到45.76%,其次为7:00～12:00,达到28.81%;干预措施后,2017年护理不良事件发生率为0.52%,明显低于2016年(p<0.05)。通过上述分析,本研究根据肿瘤病区护理不良事件发生的原因,制定有针对性的综合对策进行干预,可有效降低护理不良事件的发生率,保障患者治疗安全。
In order to investigate the nursing adverse events in the tumor area and the countermeasures of it, this study collected the incidence of nursing adverse events in cancer wards from January to December 2016, and formulated targeted countermeasures to observe the incidence of adverse events after intervention. The results showed that from January to December 2016, 59 nursing adverse events were reported in cancer ward, mainly by accidental extubation, medical advice error and drug exudation, accounting for 38.98%, 23.73% and 16.95%respectively; classification of nursing adverse events: 0 for 0 grades, 27 for Ⅱ grade, 25 for Ⅲ grade, 6 for Ⅳ grade,1 for Ⅴ grade and 0 for Ⅵ grade; the proportion of nursing adverse event occurrence in nurses with nursing work experience%<5 years was 33.33%, significantly higher than that of the nurses with working exper-ience≥5 years(p<0.05); Occurrence of nursing adverse events in nurse with professional title accounted for 30.88%, significantly higher than those with senior titles or above(p<0.05); in the time distribution of adverse events, the proportion of adverse events from 13:00 to 18:00 was the highest, reaching 45.76%, followed by 7:00 to 12:00, reaching28.81%; After the intervention, the incidence of nursing adverse events in 2017 was 0.52%, significantly lower than that in 2016(p<0.05). Based on the above analysis, according to the causes of nursing adverse events in tumor wards, this study formulated targeted comprehensive countermeasures to intervene, which might effectively reduce the occurrence of nursing adverse events and ensure the treatment safety of patients.
In order to investigate the nursing adverse events in the tumor area and the countermeasures of it, this study collected the incidence of nursing adverse events in cancer wards from January to December 2016, and formulated targeted countermeasures to observe the incidence of adverse events after intervention. The results showed that from January to December 2016, 59 nursing adverse events were reported in cancer ward, mainly by accidental extubation, medical advice error and drug exudation, accounting for 38.98%, 23.73% and 16.95%respectively; classification of nursing adverse events: 0 for 0 grades, 27 for Ⅱ grade, 25 for Ⅲ grade, 6 for Ⅳ grade,1 for Ⅴ grade and 0 for Ⅵ grade; the proportion of nursing adverse event occurrence in nurses with nursing work experience%<5 years was 33.33%, significantly higher than that of the nurses with working exper-ience≥5 years(p<0.05); Occurrence of nursing adverse events in nurse with professional title accounted for 30.88%, significantly higher than those with senior titles or above(p<0.05); in the time distribution of adverse events, the proportion of adverse events from 13:00 to 18:00 was the highest, reaching 45.76%, followed by 7:00 to 12:00, reaching28.81%; After the intervention, the incidence of nursing adverse events in 2017 was 0.52%, significantly lower than that in 2016(p<0.05). Based on the above analysis, according to the causes of nursing adverse events in tumor wards, this study formulated targeted comprehensive countermeasures to intervene, which might effectively reduce the occurrence of nursing adverse events and ensure the treatment safety of patients.
引文
Arand a-Gallardo M.,E nriquez de Luna-Rodriguez M.,CancaSanchez J.C.,Moya-Suarez A.B.,and Morales-Asencio J.M.,2015,Validation of the STRATIFY falls risk-assessment tool for acute-care hospital patients and nursing home residents:study protocol,J.Adv.Nurs.,71(8):1948-1957
Cao H.F.,Liu X.Y.,and Liu F.Y.,2016,Effect of nursing risk management in department of internal medicine nursing management,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),7(10):255-256(曹慧芳,刘向阳,刘凤云,2016,探讨护理风险管理在肿瘤内科护理管理中的效,中国卫生标准管理,7(10):255-256)
Ma H.M.,and Lu J.H.,2017,Research on effects of nursing intervention on enhancement of colonoscopy compliance of colorectal cancer high-risk population,Zhongguo Shiyong Huli Zazhi(Chinese Journal of Practical Nursing),33(12):923-927(马红梅,芦建虹,2017,护理干预对提高大肠癌高危人群肠镜依从性的效果研究,中国实用护理杂志,33(12):923-927)
Petrignani M.,van Beek J.,Borsboom G.,Richardus J.H.,and Koopmans M.,2015,Norovirus introduction routes into nursing homes and risk factors for spread:a systematic review and meta-analysis of observational studies,The Journal of Hospital Infection,89(3):163-178
Tang L.,Xu L.L.,Zhou N.,Deng B.M.,Zhang Z.L.,Wang G.B.,and Pi Y.P.,2016,The fall management strategy based on the empirical analysis of cancer inpatients,Zhongguo Huli Guanli(Chinese Nursing Management),16(10):1336-1340(唐玲,徐灵莉,周娜,邓本敏,张照莉,王国碧,皮远萍,2016,基于实证分析的肿瘤住院患者跌倒管理策略,中国护理管理,16(10):1336-1340)
Tang N.,and Qin A.L.,2016,Analysis and countermeasures on the causes of adverse events and defects in the department of neurosurgery practice of nursing students,Zhongguo Jixu Yixue Jiaoyu(China Continuing Medical Education),36(3):440-443(唐娜,秦爱玲,2016,护理学专业学生神经外科学实习中护理不良事件和缺点的原因分析与对策,中华医学教育杂志,36(3):440-443)
Tian X.F.,2016,Application value of nursing risk management in nursing management of patients in department of internal medicine,Zhongguo Jixu Yixue Jiaoyu(China Continuing Medical Education),8(25):258-259(田肖芳,2016,护理风险管理在肿瘤内科患者护理管理中的应用价值体会,中国继续医学教育,8(25):258-259)
Wang L.,Tian J.,Du L.Y.,Xie X.Y.,Xiong D.M.,Liu L.H.,and Fan H.,2016,Influencing factors and nursing countermeasures of venous thrombus in tumour patients with PICC,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),22(21):2992-2995(王莉,田静,杜凌艳,谢晓燕,熊冬梅,刘丽华,范华,2016,肿瘤患者PICC置管后发生静脉血栓的影响因素分析及护理对策,中华现代护理杂志,22(21):2992-2995)
Yang H.M.,and Liang S.L.,2016,Cause analysis and preventive measures of medical nursing risk events in medical oncology,Zhongguo YiyaoDaobao(Chinese Journal of Medical Guide),18(10):1054-1055(杨红梅,梁淑玲,2016,肿瘤内科护理风险事件的原因分析与防范措施,中国医药导刊,18(10):1054-1055)
Yu Q.,Wang C.Y.,and Guo C.H.,2015,Analysis of 210 adverse nursing events and discussion of nursing countermeasures,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),18(21):2523-2525(于清,王彩云,郭翠华,2015,210例护理不良事件原因分析及对策,中华现代护理杂志,18(21):2523-2525)
Cao H.F.,Liu X.Y.,and Liu F.Y.,2016,Effect of nursing risk management in department of internal medicine nursing management,Zhongguo Weisheng Biaozhun Guanli(China Health Standard Management),7(10):255-256(曹慧芳,刘向阳,刘凤云,2016,探讨护理风险管理在肿瘤内科护理管理中的效,中国卫生标准管理,7(10):255-256)
Ma H.M.,and Lu J.H.,2017,Research on effects of nursing intervention on enhancement of colonoscopy compliance of colorectal cancer high-risk population,Zhongguo Shiyong Huli Zazhi(Chinese Journal of Practical Nursing),33(12):923-927(马红梅,芦建虹,2017,护理干预对提高大肠癌高危人群肠镜依从性的效果研究,中国实用护理杂志,33(12):923-927)
Petrignani M.,van Beek J.,Borsboom G.,Richardus J.H.,and Koopmans M.,2015,Norovirus introduction routes into nursing homes and risk factors for spread:a systematic review and meta-analysis of observational studies,The Journal of Hospital Infection,89(3):163-178
Tang L.,Xu L.L.,Zhou N.,Deng B.M.,Zhang Z.L.,Wang G.B.,and Pi Y.P.,2016,The fall management strategy based on the empirical analysis of cancer inpatients,Zhongguo Huli Guanli(Chinese Nursing Management),16(10):1336-1340(唐玲,徐灵莉,周娜,邓本敏,张照莉,王国碧,皮远萍,2016,基于实证分析的肿瘤住院患者跌倒管理策略,中国护理管理,16(10):1336-1340)
Tang N.,and Qin A.L.,2016,Analysis and countermeasures on the causes of adverse events and defects in the department of neurosurgery practice of nursing students,Zhongguo Jixu Yixue Jiaoyu(China Continuing Medical Education),36(3):440-443(唐娜,秦爱玲,2016,护理学专业学生神经外科学实习中护理不良事件和缺点的原因分析与对策,中华医学教育杂志,36(3):440-443)
Tian X.F.,2016,Application value of nursing risk management in nursing management of patients in department of internal medicine,Zhongguo Jixu Yixue Jiaoyu(China Continuing Medical Education),8(25):258-259(田肖芳,2016,护理风险管理在肿瘤内科患者护理管理中的应用价值体会,中国继续医学教育,8(25):258-259)
Wang L.,Tian J.,Du L.Y.,Xie X.Y.,Xiong D.M.,Liu L.H.,and Fan H.,2016,Influencing factors and nursing countermeasures of venous thrombus in tumour patients with PICC,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),22(21):2992-2995(王莉,田静,杜凌艳,谢晓燕,熊冬梅,刘丽华,范华,2016,肿瘤患者PICC置管后发生静脉血栓的影响因素分析及护理对策,中华现代护理杂志,22(21):2992-2995)
Yang H.M.,and Liang S.L.,2016,Cause analysis and preventive measures of medical nursing risk events in medical oncology,Zhongguo YiyaoDaobao(Chinese Journal of Medical Guide),18(10):1054-1055(杨红梅,梁淑玲,2016,肿瘤内科护理风险事件的原因分析与防范措施,中国医药导刊,18(10):1054-1055)
Yu Q.,Wang C.Y.,and Guo C.H.,2015,Analysis of 210 adverse nursing events and discussion of nursing countermeasures,Zhonghua Xiandai Huli Zazhi(Chinese Journal of Modern Nursing),18(21):2523-2525(于清,王彩云,郭翠华,2015,210例护理不良事件原因分析及对策,中华现代护理杂志,18(21):2523-2525)