4R危机管理理论在结肠镜围检查期低血糖风险管理中的应用

Application of 4R Crisis Management Theory in risk management of hypoglycemia duringperi-colonoscopy period

目的探讨4R危机管理理论在结肠镜诊疗围检查期患者低血糖风险管理中应用的效果。方法采用便利抽样法,选择2022年3-12月在青岛市某三级甲等医院消化内科住院的372例行结肠镜诊疗的患者为对照组,采用结肠镜诊疗围检查期常规低血糖管理方法;选择2023年1-10月住院的372例行结肠镜诊疗的患者为观察组,实施基于4R危机管理理论的低血糖管理方案。比较2组患者结肠镜诊疗围检查期低血糖发生率、护士对结肠镜诊疗围检查期低血糖处置规范环节达标率、低血糖相关不良事件或并发症发生率的差异。结果观察组患者低血糖发生率低于对照组,护士对观察组患者低血糖处置规范环节达标率高于对照组,差异均具有统计学意义(P<0.05或P<0.001),2组患者低血糖相关不良事件或并发症发生率差异无统计学意义(P>0.05)。结论4R危机管理理论应用于结肠镜诊疗围检查期患者的低血糖管理中,能够有效降低患者低血糖发生率,提高护士对结肠镜诊疗围检查期低血糖处置正确率,值得在临床推广应用。

Objective To investigate the effect of 4R crisis management theory in the management of hypoglycemia risk during peri-colonoscopy period.Methods A total of 372 patients who underwent colonoscopy in the Department of Gastroenterology of a tertiary grade-A hospital in Qingdao from March to December 2022 were selected as the control group,and routine hypoglycemia management during peri-colonoscopy period was performed for the diagnosis and treatment.Another 372 patients who underwent colonoscopy from January to October 2023 were selected as the observation group,and the hypoglycemia management based on the 4R crisis management theory was implemented.The incidence of hypoglycemia during the perioperative period of colonoscopy,the compliance rate of nurses for the standardized management of patients with hypoglycemia during the perioperative period of colonoscopy,and the incidence of hypoglycemia-related adverse events or complications were compared between the two groups.Results The incidence of hypoglycemia in the observation group was lower than that in the control group,and the compliance rate of nurses in the observation group for the standardized management of patients with hypoglycemia was higher than that of the control group(P<0.05 or P<0.001).There was no significant difference in the incidence of hypoglycemia-related adverse events or complications between the two groups(P>0.05).Conclusion The 4R crisis management theory can effectively reduce the incidence of hypoglycemia and improve the accuracy of nurses’treatment of hypoglycemia during peri-colonoscopy period.It is worthy of clinical application.