天津市护理质量敏感指标闭环管理方案的构建及应用研究
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摘要
目的构建天津市护理敏感质量指标闭环管理方案,推动护理质量管理向规范化、同质化方向发展。方法参考近10年国内外护理质量评价指标文献,通过2轮专家函询,建立了天津市护理质量敏感指标集,针对各项指标,构建了天津市护理质量敏感指标闭环管理方案,并通过各级培训和反馈控制进一步完善。分别比较2015年—2017年19所三级医院的护理质量敏感指标的差异。结果天津市护理质量敏感指标闭环管理方案应用后,三级医院护理不良事件和感染事件发生率均降低,护士的离职率从1.797%下降至1.396%,差异均具有统计学意义(P<0.05)。结论天津市护理质量敏感指标闭环管理方案的应用,能降低护理不良事件发生率、感染事件发生率和护士的离职率。
Objective To develop an enclosed loop system for nursing sensitive quality indicators in Tianjin in order to enhance nursing quality management. Methods Based on National Database of Nursing Quality Indicators,sensitive quality indicators were screened,and the enclosed loop system for nursing sensitive quality indicators in Tianjin was established,and further improved by training and feedback control. Results After implementation of the system,nursing adverse events and infection events in tertiary hospitals were reduced. Conclusion The enclosed loop system for nursing sensitive quality indicators in Tianjin can reduce the rates of nursing adverse events,infection events,and nurse turnover,which can provide reference for nursing quality improvement in other areas.
Objective To develop an enclosed loop system for nursing sensitive quality indicators in Tianjin in order to enhance nursing quality management. Methods Based on National Database of Nursing Quality Indicators,sensitive quality indicators were screened,and the enclosed loop system for nursing sensitive quality indicators in Tianjin was established,and further improved by training and feedback control. Results After implementation of the system,nursing adverse events and infection events in tertiary hospitals were reduced. Conclusion The enclosed loop system for nursing sensitive quality indicators in Tianjin can reduce the rates of nursing adverse events,infection events,and nurse turnover,which can provide reference for nursing quality improvement in other areas.
引文
[1]骆金铠.护理不良事件上报信息的闭环管理[J].中国护理管理,2016,16(8):1029-1032.
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[5]祝志梅,黄丽华,冯志仙,等.产科护理质量敏感性指标的构建[J].中华护理杂志,2016,51(5):573-577.
[6]张华甫,张华,张燕,等.天津市护理质量评价核心指标体系的初步构建[J].天津护理,2016,24(6):485-488.
[7]么莉.《护理敏感质量指标实用手册(2016版)》[M].北京:人民卫生出版社,2016:5-50.
[8]王晓杰,马玉芬,徐园,等.三阶梯式培训模式在预防静脉血栓栓塞症继续教育中的应用[J].中华现代护理杂志,2016,22(18):2536-2538.
[9]覃惠英.运用科学管理手段促进护理质量持续改进[J].中国护理管理,2010,10(6):25-26.
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[11]郭红艳,谢红.美国护理质量评价体系对我国护理质量管理的启示[J].中国护理管理,2014,14(5):459-462.
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[13]汤磊雯,叶志弘,潘红英.护理质量敏感指标体系的构建与实施[J].中华护理杂志,2013,48(9):801-803.
[14]潘红英,朱陈萍,叶志弘.护理质量管理体系的建立和应用[J].护理与康复,2014,13(1):70-74.
[15]张颖,刘学芹.护理不良事件的全过程闭环管理措施浅析[J].实用医药杂志,2017,34(6):552-553.
[16]熊晓菊,黄丽红,叶天惠,等.闭环管理结合关键指标监测预防管路滑脱[J].护理学杂志,2018,33(9):56-58.
[17]中华医学会呼吸病学分会感染学组.中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J].中华结核和呼吸杂志,2018,30(4):1-3.
[18]邹鹤娟,李光辉.成人导管相关尿路感染的诊断、预防和治疗---2009年美国感染病学会国际临床实践指南[J].中国感染与化疗杂志,2010,10(5):321-324.
[19]马坚,胡必杰.导管相关性血流感染的预防控制指南2011年版本[J].中华医院感染学杂志,2011,21(12):2648-2650.
[20]牟春英,屈彦,董英.护士主导的导尿管相关性尿路感染综合预防策略的应用[J].护士进修杂志,2018,33(6):534-536.
[21]王效雷,丁兆霞,娄瑞,等.预防导尿管相关性尿路感染的环节质量控制[J].中华护理杂志,2015,50(8):1000-1003.
[22]陈泓颖,李国宏.护士离职意愿影响因素及干预的研究进展[J].护理学杂志,2017,32(12):106-108.
[23]Palese A,Cristea E,Mesaglio M,et al.Italian-Moldovan international nurse migration:rendering visible the loss of human capital[J].Intern Nurs Rev,2010,57(1):64-69.
[24]史瑞芬,刘银燕,张振路.广东省三级医院护士离职情况调查[J].中国护理管理,2016,16(11):1503-1506.
[25]韩斌如.降低护士离职率的对策与方法[J].中国医院,2014,18(5):69-70.
[2]NDNQI.Quality improvement solutions from ANA[EB/OL].(2014-04-14).http://www.nursingquality.org/About-NDNQI.
[3]Hou QJ,Crosser B,Mahnken JD,et al.Input data quality control for NDNQI national comparative statistics and quarterly reports:a contrast of three robust scale estimators for multiple outlier detection[J].BMC Res Notes,2012,456(5):1-9.
[4]Klaus S,Dunton N,Gajewski BJ,et al.Reliability of the nursing care hour measure:a descriptive study[J].Int J Nurs Stud,2013,50(7):924-932.
[5]祝志梅,黄丽华,冯志仙,等.产科护理质量敏感性指标的构建[J].中华护理杂志,2016,51(5):573-577.
[6]张华甫,张华,张燕,等.天津市护理质量评价核心指标体系的初步构建[J].天津护理,2016,24(6):485-488.
[7]么莉.《护理敏感质量指标实用手册(2016版)》[M].北京:人民卫生出版社,2016:5-50.
[8]王晓杰,马玉芬,徐园,等.三阶梯式培训模式在预防静脉血栓栓塞症继续教育中的应用[J].中华现代护理杂志,2016,22(18):2536-2538.
[9]覃惠英.运用科学管理手段促进护理质量持续改进[J].中国护理管理,2010,10(6):25-26.
[10]汪迪峰.数据完整率指标的系统运维保证[J].中国电力企业管理,2013,33(6):28-30.
[11]郭红艳,谢红.美国护理质量评价体系对我国护理质量管理的启示[J].中国护理管理,2014,14(5):459-462.
[12]徐厚丽.优质护理服务质量管理评价指标体系研究及应用[D].济南:山东大学,2013.
[13]汤磊雯,叶志弘,潘红英.护理质量敏感指标体系的构建与实施[J].中华护理杂志,2013,48(9):801-803.
[14]潘红英,朱陈萍,叶志弘.护理质量管理体系的建立和应用[J].护理与康复,2014,13(1):70-74.
[15]张颖,刘学芹.护理不良事件的全过程闭环管理措施浅析[J].实用医药杂志,2017,34(6):552-553.
[16]熊晓菊,黄丽红,叶天惠,等.闭环管理结合关键指标监测预防管路滑脱[J].护理学杂志,2018,33(9):56-58.
[17]中华医学会呼吸病学分会感染学组.中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J].中华结核和呼吸杂志,2018,30(4):1-3.
[18]邹鹤娟,李光辉.成人导管相关尿路感染的诊断、预防和治疗---2009年美国感染病学会国际临床实践指南[J].中国感染与化疗杂志,2010,10(5):321-324.
[19]马坚,胡必杰.导管相关性血流感染的预防控制指南2011年版本[J].中华医院感染学杂志,2011,21(12):2648-2650.
[20]牟春英,屈彦,董英.护士主导的导尿管相关性尿路感染综合预防策略的应用[J].护士进修杂志,2018,33(6):534-536.
[21]王效雷,丁兆霞,娄瑞,等.预防导尿管相关性尿路感染的环节质量控制[J].中华护理杂志,2015,50(8):1000-1003.
[22]陈泓颖,李国宏.护士离职意愿影响因素及干预的研究进展[J].护理学杂志,2017,32(12):106-108.
[23]Palese A,Cristea E,Mesaglio M,et al.Italian-Moldovan international nurse migration:rendering visible the loss of human capital[J].Intern Nurs Rev,2010,57(1):64-69.
[24]史瑞芬,刘银燕,张振路.广东省三级医院护士离职情况调查[J].中国护理管理,2016,16(11):1503-1506.
[25]韩斌如.降低护士离职率的对策与方法[J].中国医院,2014,18(5):69-70.