精神科“六防”风险评估表在降低住院患者意外事件中的应用

Application of“six preventions” risk assessment form in psychiatry to reduce the accidents occurrence among inpatients

目的：探讨精神科“六防”风险评估表在降低住院患者发生意外事件中的应用效果。方法按入院时间将233例患者分为对照组和干预组，将2011年5月至2012年2月住院的116例患者设为对照组，将2012年3-12月住院的117例患者设为干预组。干预组患者入院后，护士运用自制精神科“六防”风险评估表（防冲动、防外跑、防藏药、防自弃、防跌倒和防噎食）进行风险评估，根据评分结果划分为高、中、低三个风险等级，实施分层护理干预，而对照组接受常规治疗和护理。比较分析两组患者意外事件发生率。结果两组患者意外事件发生次数、发生率进行比较，干预组发生3例，发生率为2．56％，对照组发生24例，发生率为20．69％，两组比较差异有统计学意义（χ2＝18．67，P＜0．01）。不同性别、年龄患者意外事件发生率比较差异无统计学意义（ P＞0．05）。干预组不同分型、不同病程患者意外事件发生率的差异无统计学意义（P＞0．05）；而对照组不同分型、不同病程患者意外事件发生率差异有统计学意义（χ2值分别为14．63，7．79；P＜0．05），精神分裂症和病程1年以下患者意外事件的发生率最高，两组组间比较差异有统计学意义（χ2值分别为23．62，23．45；P＜0．01）。结论采用精神科“六防”风险评估表对住院患者进行分层护理，可有效降低意外事件的发生。

Objective To discuss the effect of “six preventions” risk assessment form in psychiatry to reduce the accidents occurrence among inpatients .Methods By the time of admission , 233 inpatients were divided into control and intervention group ,from May 2011 to December 2012 as the control group （116 cases）, from March 2012 to December 2012 as intervention group （ 117 cases ） .After the patients were admitted to hospital in the intervention group , psychiatric nursesusedself-designed “six preventions” risk assessment form （ impulsion prevention ,running-outprevention , hiding medicine prevention , self-abandonprevention , falling down prevention , and choking prevention ） to assess the risk , divided into high , medium and low risk level according to the rating results , and then implemented tiered nursing intervention , while the control group received routine treatment and nursing .Results Comparing the number and rate of accidents occurrence in the two groups ,the intervention group had three cases with a rate of 2.56%, and the control group had 24 cases with a rate of 20.69%.The difference was statistically significant （χ2 =18.67, P〈0.01）.For the intervention group, the comparison of the rate of accidents between different types and durations showed no statistical significance （ P＆gt;0.05）.For the control group, the comparison of the rate of accidents between different types and durations showed a statistical significance （χ2 =14.63,7.79,respectively;P〈0.05）.Schizophrenia and duration less than 1 year contributed the higher rate of accidents occurrence with a statistical significance （χ2 =23.62, 23.45, respectively;P〈0.01）.Conclusions Adopting psychiatric risk assessment form of “six prevention” to stratify inpatients can effectively reduce the rate of accidents occurrence .