护理敏感质量指标在不良事件管理持续改进中应用的效果评价
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摘要
[目的]评价护理敏感质量指标在不良事件管理持续改进中的应用效果。[方法]采用方便抽样法选取全院共40个普通病区收住的病人为研究对象。根据病人住院时间分为对照组和观察组,对照组为2015年1月—2016年12月40个病区收治的109 623例住院病人,观察组为2017年1月—2018年12月40个病区收治的123 020例住院病人。对照组按医院质量控制要求的相关制度进行不良事件管理,主要是鼓励主动上报;观察组则是运用国家护理质量控制中心编制的《护理敏感质量指标实用手册(2016版)》相关护理敏感质量指标进行不良事件管理。比较两组不良事件发生率及漏报率、月度护理质量和病人满意度。[结果]两组住院病人跌倒、院内压力性损伤、非计划性拔管、危重病人呼吸机相关性肺炎(VAP)、危重病人导尿管相关性感染(CAUTI)、不良事件漏报率、病人满意度和月度护理质量差异有统计学意义(P<0. 05)。[结论]将护理敏感质量指标应用于不良事件管理中,能有效降低不良事件发生率和漏报率,有利于不良事件管理和护理质量持续改进,提升护理工作满意度。
引文
[1]杨莘,王祥,邵文利,等.335起护理不良事件分析及对策[J].中华护理杂志,2010,45(2):130-132.
[2]周珺,赵梅,董旭婷,等.护理不良事件报告障碍与医院患者安全文化的相关性研究[J].中国护理管理,2014,14(1):83-85.
[3]LIU S W,SINGER S J,SUN B C,et al.A conceptual model for assessing quality of care for patients boarding in the emergency department:structure-process-outcome[J].Academic Emergency Medicine,2011,18(4):430-435.
[4]BARACH P,SMALL S D.Reporting and preventing medical mishaps:lessons from non-medical near miss reporting systems[J].British Medical Journal,2000,320:759-763.
[5]BAKER G R,NORTON P G,FLINTOFT V,et a1.The Canadian adverse events study:the incidence of adverse events among hospital patients in Canada[J].Journal of the American Chemical Sociaty,2004,170(11):1678-1686.
[6]WOODS D,THOMAS E,HOLL J,et a1.Adverse events and preventable adverse events in children[J].Pediatrics,2005,115(1):155-160.
[7]HESLOP L,LU S.Nursing-sensitive indicators:a concept analysis[J].Journal of Advanced Nursing,2014,70(11):2469-2482.
[8]PODGORNY K L.Developing nursing-focused quality indicator:a professional challenge[J].Nurs Care Qual,1991,6(1):47-52.
[9]BURSTON S,CHABOYER W,GILLESPIE B,et al.Nursesensitive indicators suitable to reflect nursing care quality:a review and discussion of issues[J].Journal of Clinical Nursing,2014,23(13):1785-1795.
[10]GALLAGHER R M,ROWELL P A.Claiming the future of nursing through nursing-sensitive quality indicators[J].Nurs Adm Q,2003,27(4):273-284.
[11]么莉,护理敏感质量指标实用手册[M].北京:人民卫生出版社,2016:6.
[12]简伟研,周宇奇,吴志军,等.护理敏感质量指标的发展和应用[J].中国护理管理,2016,16(7):865-868.
[13]冯志仙,黄丽华,章梅云,等.护理敏感质量指标的构建及应用[J].中国护理管理,2014,14(5):452-455.
[14]李智英,成守珍,吕林华,等.护理敏感质量指标在优质护理评价及持续改进中的应用[J].中华护理杂志,2014,49(1):1168-1171.
[15]杨玉茹.护理敏感质量指标在护理质量管理中的应用效果[J].四川医学,2017,38(5):597-598.
[16]DE L J,PRINS J B,TEERENSTRA S,et al.Nurse-led follow-up care for head and neck cancer patients:a quasi-experimental prospective trial[J].Supportive Care in Cancer,2013,21(2):537-547.
[17]TRUE B A,COCHRANE C C,SLEUTEL M R,et al.Developing and testing a vaginal delivery safety check checklist[J].J Obstet Gynecologic Neonatal Nurs,2016,45(2):239-248.
[18]冯翔,田俊,王斌全,等.护士主导的喉癌术后患者随访清单的制订[J].中华护理杂志,2019,49(1):956-961.
[19]张华芳,黄丽华.护理质量敏感性指标的研究进展[J].中华护理杂志,2014,49(8):991-993.
[2]周珺,赵梅,董旭婷,等.护理不良事件报告障碍与医院患者安全文化的相关性研究[J].中国护理管理,2014,14(1):83-85.
[3]LIU S W,SINGER S J,SUN B C,et al.A conceptual model for assessing quality of care for patients boarding in the emergency department:structure-process-outcome[J].Academic Emergency Medicine,2011,18(4):430-435.
[4]BARACH P,SMALL S D.Reporting and preventing medical mishaps:lessons from non-medical near miss reporting systems[J].British Medical Journal,2000,320:759-763.
[5]BAKER G R,NORTON P G,FLINTOFT V,et a1.The Canadian adverse events study:the incidence of adverse events among hospital patients in Canada[J].Journal of the American Chemical Sociaty,2004,170(11):1678-1686.
[6]WOODS D,THOMAS E,HOLL J,et a1.Adverse events and preventable adverse events in children[J].Pediatrics,2005,115(1):155-160.
[7]HESLOP L,LU S.Nursing-sensitive indicators:a concept analysis[J].Journal of Advanced Nursing,2014,70(11):2469-2482.
[8]PODGORNY K L.Developing nursing-focused quality indicator:a professional challenge[J].Nurs Care Qual,1991,6(1):47-52.
[9]BURSTON S,CHABOYER W,GILLESPIE B,et al.Nursesensitive indicators suitable to reflect nursing care quality:a review and discussion of issues[J].Journal of Clinical Nursing,2014,23(13):1785-1795.
[10]GALLAGHER R M,ROWELL P A.Claiming the future of nursing through nursing-sensitive quality indicators[J].Nurs Adm Q,2003,27(4):273-284.
[11]么莉,护理敏感质量指标实用手册[M].北京:人民卫生出版社,2016:6.
[12]简伟研,周宇奇,吴志军,等.护理敏感质量指标的发展和应用[J].中国护理管理,2016,16(7):865-868.
[13]冯志仙,黄丽华,章梅云,等.护理敏感质量指标的构建及应用[J].中国护理管理,2014,14(5):452-455.
[14]李智英,成守珍,吕林华,等.护理敏感质量指标在优质护理评价及持续改进中的应用[J].中华护理杂志,2014,49(1):1168-1171.
[15]杨玉茹.护理敏感质量指标在护理质量管理中的应用效果[J].四川医学,2017,38(5):597-598.
[16]DE L J,PRINS J B,TEERENSTRA S,et al.Nurse-led follow-up care for head and neck cancer patients:a quasi-experimental prospective trial[J].Supportive Care in Cancer,2013,21(2):537-547.
[17]TRUE B A,COCHRANE C C,SLEUTEL M R,et al.Developing and testing a vaginal delivery safety check checklist[J].J Obstet Gynecologic Neonatal Nurs,2016,45(2):239-248.
[18]冯翔,田俊,王斌全,等.护士主导的喉癌术后患者随访清单的制订[J].中华护理杂志,2019,49(1):956-961.
[19]张华芳,黄丽华.护理质量敏感性指标的研究进展[J].中华护理杂志,2014,49(8):991-993.