4R危机管理对神经内科住院患者医院感染的影响

Influence of 4R crisis management on nosocomial infections in hospitalized patients of neurology department

目的探讨4R危机管理对神经内科住院患者医院感染的影响。方法选取2015年1月-2016年6月医院神经内科住院患者2 828例,依据入院时间分为4R组(2015年10月-2016年6月)1 432例和对照组(2015年1月-2015年9月)1 396例;比较两组感染类型、护理质量、机械通气时间、ICU住院时间、总住院时间及护理投诉、满意率。结果 2 828例神经内科住院患者中,发生医院感染94例,感染率为3.32%,其中4R组1 432例,医院感染7例,感染率为0.49%,对照组1 396例,感染87例,感染率为6.23%;4R组的基础护理管理、病房管理、文书管理、护患沟通管理、药品管理、重点环节管理、总分均明显高于对照组,差异有统计学意义(P<0.05);4R组患者的机械通气时间、ICU住院时间及总住院时间均明显低于对照组,差异有统计学意义(P<0.05);4R组护患纠纷率、投诉率、满意率分别为1.68%、1.40%、97.97%,对照组护患纠纷率、投诉率、满意率分别为6.81%、6.23%、83.02%。结论 4R危机管理能够明显降低神经内科住院患者的医院感染风险,提高护理质量,优化患者术后康复效果,患者满意率较高。

OBJECTIVE To explore the＇influence of 4R crisis management on nosocomial infections m hospttaltzeu patients of neurology department. METHODS A total of 2 828 patients who were hospitalized the neurology department from Jan 2015 to Jun 2016 were enrolled in the study and divided into the 4R group with 1 432 cases （from Oct 2015 to Jun 2016） and the control group with 1 396 cases （from Jan 2015 to Sep 2015） according to the time of admission. The types of infections, nursing quality, mechanical ventilation duration, length of ICU stay, total length of hospital stay, complaints of nursing, and satisfaction rate were observed and compared between the two groups. RESULTS Of the 2 828 hospitalized patients of neurology department, 94 had nosoeomial infections, with the infection rate 3.32% ; the nosocomial infections occurred in 7 of 1432 patients in the 4R group, with the infection rate 0.49 %, and the nosoeomial infections occurred in 87 of I 396 patients in the control group, with the infection rate 6.23%. The scores of primary care management, ward management, document management, nursepatient communication management, drug management and key link management as well as total score were significantly higher in the 4R group than in the control group（P〈0.05）. The nurse-patient dispute rate was 1.68% in the 4R group, 6.81% in the control group; the complaint rate was 1.40% in the 4R group, 6. 23% in the control group; the satisfaction rate was 97.97% in the 4R group, 83, 02% in the control group. CONCLUSION The 4R management can remarkably reduce the risk of nosocomial infections in the hospitalized patients of neurology department, improve the nursing quality and optimize the effect of postoperative rehabilitation, and the patients; satisfaction rate is high.