护理安全风险管理防御机制在手术室护理管理中的应用

Application of nursing safety risk management in the operating room

目的：探讨手术室护理过程中护理安全风险管理的防御效果，寻找风险管理防御机制，以更好地为患者服务。方法选择2011年7月-2013年6月330例手术患者作为观察组，回顾性分析2010年4月-2011年6月手术治疗的患者330例作为对照组。观察组患者给予风险防御手术室管理流程模式，对照组采取传统手术室护理管理模式。比较两组患者风险事件发生率、护理投诉纠纷情况、满意度和手术室护士风险管理掌握情况。结果实施风险管理后，观察组手术护理工作中的术前准备失误率、护理记录差错率、无菌操作不当发生率、切口感染发生率、护理投诉纠纷发生率分别为0．30％，0．00％，0．00％，0．00％，0．00％，均优于对照组的1．52％，1．21％，0．91％，0．30％，0．91％，差异有统计学意义（χ2值分别为4．32，4．07，4．05，4．22，4．25；P ＜0．05）。观察组患者对护理工作综合满意度为99．1％，高于对照组的85．2％，差异有统计学意义（χ2＝4．283，P＜0．05）。观察组护理人员风险意识、风险管理认识、风险管理态度、风险管理行为意向评分分别为（23．1±7．3），（25．3±5．3），（21．2±4．6），（22．5±6．1）分，均高于对照组的（16．7±5．8），（17．3±6．1），（15．3±3．2），（16．3±2．6）分，差异有统计学意义（t值分别为4．28，4．29，4．16，6．05；P＜0．05）。结论手术室护理过程中实施护理安全风险管理防御机制效果明显，有效降低了风险事件的发生，提高了手术室护士的风险意识，保障了患者的安全。

Objective To explore the nursing safety risk management in the process of the operating room nursing defense and find the existing problems .Methods From July 2011 to June 2013 , 330 patients were recruited as the observation group .We retrospectively analyzed another 330 patients from April 2010 to June 2011 , as the control group .The observation group patients were given safety risk management , while the control group adopted the traditional operating room nursing management mode .The incidence of risk events and nursing complaints disputes were compared between groups .Results After the implementation of risk management , the preoperative preparation errors , the nursing record error rate , sterile improper rate , infection of incision rate and nursing dispute complaint rate were 0.30%, 0.00%, 0.00%, 0.00%, 0.00%, respectively, in the observation group, which were significantly better than 1.52%, 1.21%, 0.91%, 0.30%, 0.91% in the control group （χ2 =4.32,4.07,4.05,4.22,4.25, respectively;P＆lt;0.05）.The patients’ satisfaction was 99.13%of the observation group and 85.22% of the control group .The difference was statistically significant （χ2 =4.283,P〈0.05）.The score of risk awareness, risk management, risk management attitude and risk management behavior intention were （23.1 ±7.3）, （25.3 ±5.3）, （21.2 ±4.6）, （22.5 ±6.1） of the observation group, and （16.7 ±5.8）, （17.3 ±6.1）, （15.3 ±3.2）, （16.3 ±2.6） of the control group. The differences were statistically significant （ t =4.28, 4.29, 4.16, 6.05, respectively;P〈0.05 ）. Conclusions The nursing safety risk management has an obvious effect .It can effectively reduce the risk events, and increase the risk awareness of operating room nurses and guarantee the safety of patients .