护理巡查日志对护理质量控制的影响

Application of nursing inspection log on nursing quality control

目的 探讨护理巡查日志在护理质量控制中的作用.方法 在10个病区中,采用信封随机抽取5个病区作为干预组,从2012年1月开始护士长使用护理巡查日志,结合五查房每天对日常工作有重点的巡查,及时记录与反馈,每周对上周检查中存在的问题予以复查,护士长不在班时由指定的人负责质控并记录,科护士长对平时质控情况定期予以抽查.另外的5个病区作为对照组,护士长未使用护理巡查日志,采用传统的质量控制方法.比较两组的质量控制及不良事件发生情况.结果 干预组核心制度的执行情况、出入院护理质量、重患者护理质量、护理文件书写质量、消毒隔离质量、病房管理质量出现问题的次数分别为26,28,25,15,10,14次,分别少于对照组的52,48,40,30,23,28次,两组比较差异有统计学意义（x2分别为11.93,7.45,4.87,6.32,6.17,5.86;P ＜0.05）.对照组5个病区共出院6 259例,干预组出院6 347例,汇总全年不良事件,干预组发生不良事件的人次为32例（0.50％）,明显少于对照组的73例（1.17％）,两组比较差异有统计学意义（x2 =16.73,P＜0.05）.结论 巡查日志可以明显提高护理质量,减少不良事件的发生率.

Objective To study the role of nursing inspection log in the management of nursing quality control.Methods Totals of 10 wards of internal medicine were randomized into the intervention group （5 wards） and the control group （5 wards）.From January 2012,nursing inspections log was used in the intervention group,combined with the rounds of the wards to inspect the daily work.The existed problem of last week was reviewed every week.Specified nurse was responsible for the quality control and recorded when the head nurse was off the shift.The head nurse checked the results of quality control regularly.The incidence of adverse events and quality control results were compared between groups.Results In the intervention group,the times of adverse events of completion of core system,nursing quality of hospital admission and discharge,nursing quality of severe patients,quality of nursing document,quality of disinfection and isolation and quality of wards＇ management were 26,28,25,15,10 and 14,which were less than 52,48,40,30,23 and 28 in the control group.The differences were significant （x2 =11.93,7.45,4.87,6.32,6.17,5.86,respectively; P 〈 0.05）.The control group discharged 6 259 patients,and the intervention group discharged 6 347 patients.The total number of adverse events was 32 patients in the intervention group （0.50%） and 73 patients in the control group （1.17%）.The difference was significant （x2 =16.73,P 〈 0.05）.Conclusions The inspection log can improve nursing quality control and decrease adverse events.