住院患者护理高危风险闭环式预警评估系统的建立与应用
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摘要
目的通过住院患者护理高危风险闭环式预警评估系统,构建住院患者护理高危风险预警管理的有效模式。方法应用医院计算机网络对所有住院患者的护理风险进行评估、录入,筛选出住院患者护理高危风险因素,系统自动推出每日安全评估提醒及安全措施,患者出院后系统结束提醒功能,从而达到对住院患者护理高危风险的前瞻闭环管理。结果住院患者护理风险评估预警提醒系统实施后,皮肤压力性损伤发生率、跌倒、意外拔管发生率等和重症监护病房导管感染率与实施前比有统计学意义(P<0.01或P<0.05)。结论住院患者护理高危风险闭环式预警评估系统提高了护士对护理风险的预见性及风险管理意识,减少了护理不良事件的发生,能够促进护理质量持续改进。
Objective To build an effective early warning management model of high nursing risk,through early closed-loop warningassessment system.Methods Using hospital computer network to assess nursing risk of inpatients to screen high risk factors.The system auto-matically pushed safety assessments and measures to each inpatient daily and closed reminder function after discharge,thus reaching prospec-tive closed-loop management of high nursing risk.Results After implementation of early warning assessment system of hospitalized patientshigh nursing risk,the incidence of pressure ulcers,fall down,accidental decannulation rate and central venous catheter infection rate had sta-tistically differences compared with before(P<0.01 orP<0.05).Conclusion The closed-loop early warning assessment system can helpnurses to improve the nursing risk predictability and management level,and reduced the occurrence of nursing adverse events,which can pro-mote the continuous improvement of nursing quality.
Objective To build an effective early warning management model of high nursing risk,through early closed-loop warningassessment system.Methods Using hospital computer network to assess nursing risk of inpatients to screen high risk factors.The system auto-matically pushed safety assessments and measures to each inpatient daily and closed reminder function after discharge,thus reaching prospec-tive closed-loop management of high nursing risk.Results After implementation of early warning assessment system of hospitalized patientshigh nursing risk,the incidence of pressure ulcers,fall down,accidental decannulation rate and central venous catheter infection rate had sta-tistically differences compared with before(P<0.01 orP<0.05).Conclusion The closed-loop early warning assessment system can helpnurses to improve the nursing risk predictability and management level,and reduced the occurrence of nursing adverse events,which can pro-mote the continuous improvement of nursing quality.
引文
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[15]田丹,孙璇,张美芳.ICU护士多重耐药菌感染防控认知及建议[J].护理管理杂志,2016,16(4):270-272.
[16]邓俊,蒙景雯,任军红.基于感染管理护士为主体的医院感染管理实践[J].护理管理杂志,2017,17(1):50-51.
[17]林乐丹,孙素珍,何乐琼,等.ICU医院感染危险因素及综合护理措施对预后的影响[J].中华医院感染学杂志,2017,27(12):2845-2848.DOI:10.11816/cn.ni.2017-170233.
[18]曾定芬,陈付红,杨蓉.护理风险管理在ICU的应用[J].护理研究,2009,23(4A):906-908.DOI:10.3969/j.issn.1009-6493.2009.10.028.
[19]刘霞,杨贵云,张泓,等.导道滑脱风险跟踪评估监控流程的设计及应用[J].护理学杂志,2014,29(20):5-7.DOI:10.3870/hlxzz.2014.20.005.
[20]杨程显,李戈,张立颖.Braden量表评估压疮风险的研究进展及展望[J].护理学报,2014,21(7):25-27.
[2]吴茜,龚美芳,孙晓,等.住院患者护理高危风险预警预控体系构建与运作[J].护理学报,2015,22(1):16-20.DOI:10.16460/j.issn1008-9969.2015.01.016.
[3]张蕾,鲍莹,孟慧.预警护理在EV71型重症手足口病合并神经系统损害患儿中的应用研究[J].护理管理杂志,2017,17(6):427-229.
[4]孙晓敏,丁雅英,汪虹,等.住院患者护理风险评估预警监控传报系统的建立与应用效果评价[J].中国护理管理,2017,17(3):378-382.DOI:10.3969/j.issn.1672-1756.2017.03.022.
[5]谢萍,周慧勤.基于网络平台的闭环式护理不良事件警讯上报系统的应用[J].护理管理杂志,2015,15(11):821-823.
[6]李政,陈亚红,樊树峰,等.同质化管理对非内分泌科护士处理低血糖能力的影响[J].护理管理杂志,2017,17(6):436-437.
[7]VINCENT C,ADAMS A T,CHAPMAN E J,et al.How to investigate and analyse clinical incidents:clinical risk unit and association of litigation and risk management protocol[J].British Medical Journal,2000,320(7237):777-781.
[8]李瑶,喻姣花.护理不良事件讨论会在患者安全管理的实践[J].护理学杂志,2017,32(1):47-49.DOI:10.3870/j.issn.1001-4152.2017.01.047.
[9]陆宏伟.前馈控制在产科连台手术护理安全管理中的效果研究[J].护理管理杂志,2016,16(11):823-825.
[10]徐雪芳,余国峰,齐向红,等.微信平台在降低肿瘤患者PICC非计划性拔管中的应用[J].护理管理杂志,2017,17(4):302-304.
[11]肖峰,赵庆华,喻秀丽,等.老年护理院护理安全管理评价指标体系的研制[J].中国护理管理,2014,14(1):13-16.DOI:10.3969/j.issn.1672-1756.2014.001.003.
[12]王灵晓,刘翠青,张瑞英.骨科病房预防下肢深静脉血栓形成的护理现状调查[J].护理管理杂志,2013,13(7):489-490.
[13]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.DOI:10.3969/j.issn.1672-1756.2016.08.006.
[14]谢建飞,丁四清,钟竹青,等.综合干预护理中断事件对护理安全管理的影响[J]护理研究,2014,28(4):1167-1170.
[15]田丹,孙璇,张美芳.ICU护士多重耐药菌感染防控认知及建议[J].护理管理杂志,2016,16(4):270-272.
[16]邓俊,蒙景雯,任军红.基于感染管理护士为主体的医院感染管理实践[J].护理管理杂志,2017,17(1):50-51.
[17]林乐丹,孙素珍,何乐琼,等.ICU医院感染危险因素及综合护理措施对预后的影响[J].中华医院感染学杂志,2017,27(12):2845-2848.DOI:10.11816/cn.ni.2017-170233.
[18]曾定芬,陈付红,杨蓉.护理风险管理在ICU的应用[J].护理研究,2009,23(4A):906-908.DOI:10.3969/j.issn.1009-6493.2009.10.028.
[19]刘霞,杨贵云,张泓,等.导道滑脱风险跟踪评估监控流程的设计及应用[J].护理学杂志,2014,29(20):5-7.DOI:10.3870/hlxzz.2014.20.005.
[20]杨程显,李戈,张立颖.Braden量表评估压疮风险的研究进展及展望[J].护理学报,2014,21(7):25-27.