以问题为基础进行跌倒专题查房在护理安全管理中的持续质量改进

Study of problems-based administrative ward round on safe quality improvement of fall

目的:进行跌倒专题的护理查房,以问题为基础进行持续质量改进。方法:针对48例跌倒事件采用PBL教学的方法进行分析讨论,逐步找出问题关键,分析护理安全管理存在问题并加以解决。结果:2013至2014年度全院跌倒高风险上报率4.50%提高至14.80%,各重点科室如骨科、神经外科、呼吸内科、康复科跌到高风险上报率亦逐步提升,住院患者跌倒严重程度例数同期减少,差异有统计学意义(P<0.05)。结论:管理模式的改变拓展了护理管理人员和护士的知识面,通过管理者和临床一线护士的思维碰撞,进行系统管理层面和专科护理层面问题的分析,建立相关制度和制订临床流程指引,提高了护士、陪护人员和患者及家属的防跌倒意识,预防不良事件的发生,确保患者安全。

Objective： To explore the effective quality improvement method on falling. Methods： According to problems-based leaning in nursing ward round, we discussed the key reason of the fall events, and found out the problems and solutions in safety management.Results ： The reported rate of high fall risk increased from 4.5% to 14.8% from 2013 to 2014. It was increased in all important departments such as orthopaedics, neurosurgery, respiratory, rehabilitation. The serious injury cases after fall reduced at the same time（P〈0.05）. Conclusion： The new management mode can improve management level of fall prevention by increasing knowledge of nurses and their administrators.