运用海恩法则进行乳腺日间病房护理安全风险管理

Effect of Haien Rule on Risk Management of Nursing Safety in Breast Day-care Ward

目的探讨在乳腺日间化疗病房运用海恩法则进行安全管理,降低护理风险过程中的应用效果。方法对120例乳腺癌患者,在日间病房化疗期间以海恩法则为指导,针对病房存在的问题及护理隐患,采取护理风险安全管理措施,包括:应用移动护理系统准确识别患者身份,设计化疗药物名片及出院带药名片确保安全用药,运用导图式护理思维降低化疗不良反应,汇编日间病房标准化作业程序手册,监督护理质量及感染控制等。结果 120例化疗患者均未出现护理相关并发症,未发生护理差错与事故,未发生护理纠纷与投诉;仅发生经外周静脉穿刺中心静脉导管堵管2例,经外周静脉穿刺中心静脉导管感染1例,跌倒1例,用药错误1例,经及时发现及积极处理后,未形成事实或未对患者机体和功能造成损害。专科护理质量评分为97.37分,服药依从问卷评价为高度依从,患者对护理工作的满意率为95.8%,所有患者均顺利完成化疗。结论针对日间病房的运行模式及乳腺癌化疗患者的护理需求,运用海恩法则进行护理安全风险管理,能够降低日间病房护理安全不良事件的发生,提升专科护理质量,提高患者满意度。

Objective To explore the effect of Haien Rule on risk management of nursing safety in breast day-care chemotherapy ward. Methods We summarized the experience of risk management guided by Haien Rule in breast day-care chemotherapy ward and corresponding measures included patients ＇ identity identification through mobile nursing system, chemotherapy medication card to ensure the safety of medication-taking, nursing thinking with mind maps to reduce side effect of chemotherapy and standard procedure manual in day-care chemotherapy ward for nursing quality control and infection control. Results No nursing-related complications, no nursing errors and accident, no nursing disputes and complaints occurred among 120 patients. Two cases of PICC catheter blockage, 1 case of PICC infection, 1 case of falling and 1 case of medication error occurred but there was no damage to patients when processed timely. The quality assessment score of nursing specialist was 97.37. Patients presented good compliance in the investigation of medication compliance and 95.8% of the patients were satisfied with the nursing and completed the chemotherapy.Conclusion Nursing risk management based on Haien Rule benefits decreasing the incidence of nursing adverse events and enhancing nursing quality and patients＇ satisfaction.