精神科急重症病区护理管理模式的建立

Exploration of nursing management model of psychiatry intensive care unit

目的建立一套适合精神科急重症病区(PICU)的护理管理模式。方法选择2003年4月—2007年3月PICU作为研究对象,将PICU分为2003年4月—2005年3月与2005年4月—2007年3月两组垂直对照,前者为对照组,后者为研究组。对照组护理人员按常规排班制及实施常规工作制度。研究组实施常规排班与弹性排班制相结合的方法,合理配置人力资源;并在原有基础上制订和健全与PICU相配套的各项规章制度。根据护理质量考核指标,比较两组护理差错发生情况及患者的暴力倾向与暴力行为发生情况。结果研究组护理质量各项检查结果与对照组比较差异有统计学意义(P≤0.05);满意率研究组较对照组上升了4.39%;护理差错和意外事件发生率研究组较对照组下降了40%;患者暴力倾向和暴力行为的发生例次研究组较对照组分别下降了42.48%和46.07%。结论制订和实施与PICU相适应的一系列规章制度符合PICU的需求,能提升护理质量及满意率,降低护理风险,使有限的人力资源发挥其最大的作用。

Objective To explore the nursing management model of psychiatry intensive care unit （PICU）. Methods The PICUs from April 2003 to March 2007 were separated into two groups. The control group was from April 2003 to March 2005 and the nursing staff used regular shift management and regular work system. The experimental group was from April 2005 to March 2007. The nursing staff used regular shift management but combined with flexible shift system and suitable assignment of manpower. On the basis of original ones, The regulations were modified to suit the PICU system. The nursing quality check including satisfaction evaluation, nursing defect, and violent behavior of patients was analysed. Results All the above-mentioned indexes were significantly different （P≤0.05）. Compared with those in control group, satisfaction was increased by 4.39% , nursing defect was decreased by 40% , and violent tendency and behavior of patients were decreased by 42.48% and 46.07% in experimental group, respectively. Conclusion Thorough implementation of the rules and regulations for PICU can improve the nursing quality and satisfaction of patients, reduce the risk of nursing, and make limited manpower exert the best effect.