护理风险管理干预对冠心病介入治疗患者护理质量及满意度的影响

The influence of nursing-risk management on nursing quality and satisfaction of the patients who received intervention operation of the coronary heart disease

目的 分析护理风险管理对冠心病介入治疗患者手术潜在性伤害及满意度的影响,为临床应用提供依据.方法 将我院2014年1月至2015年3月行介入治疗的108例冠心病患者随机分为对照组和观察组各54例;患者依照分组不同采用不同的护理干预方案,对照组患者行常规护理干预措施进行护理,主要包括饮食、用药、检查等;观察组患者采用PDCA循环式风险管理护理策略进行干预,对患者制定个性化的护理方案,有效预防及管控风险;对患者治疗过程中负性效应、并发症、血糖、血压及心电图异常发生率进行分析,统计分析护理不安全因素的发生率,并使用我院自主设计的量表对两组护理质量及患者满意度进行调查.结果 观察组患者心律失常、低血糖、穿刺血管损伤并发症临床发病率、排尿困难、血肿或出血、便秘、迷走神经反射、腰酸背痛、入睡困难、低血压及肢体活动疼痛等负性效应发生率低于对照组,差异有统计学意义（P＜0.05）;观察组患者血压、血糖、心电图异常发生率均低于对照组,差异有统计学意义（P＜0.05）;观察组患者不合理运动、大便后胸闷、不合理用药、低血糖反应、空腹血糖偏低、空腹血糖偏高、随意饮食及心绞痛等不安全因素发生率低于对照组,差异有统计学意义（P＜0.05）;观察组患者介入护理质量、基础护理质量、护理表格书写质量评分高于对照组,差异有统计学意义（P＜0.05）;观察组患者服务态度、术后病情进展、术前健康教育、病情进展告知、术后健康教育及总体工作评价均优于对照组,差异有统计学意义（P＜0.05）.结论 采用护理风险管理可显著降低冠心病介入治疗患者手术潜在性伤害风险,提高护理质量及护理满意度,具有较高的应用价值.

Objective To analyze the influence of nursing-risk management on the potential harm and satisfac-tion of the patients who received intervention operation of the coronary heart disease and to provide basis for clinical ap-plication. Methods A total of 108 cases of patients who have received the intervention operation of the coronary heart disease from January 2014 to March 2015 in our hospital were randomly divided into observation group and control group. The patients of different groups adopted different nursing intervention methods. The control group received rou-tine nursing intervention measures, including diet, medication and check. While patients of the observation group were intervened by the PDCA cycling-style risk-management strategies and were treated by the individualized care program with effective prevention and control of risk. The negative effect, complications, blood glucose, blood pressure and ECG abnormal rate during the treatment was analyzed. And the incidence of unsafe factors of nursing care was analyzed statistically as well. The quality of nursing and satisfaction of the patients of the two groups was investigated by our hos-pital self-designed scale surve. Results The incidence rate of arrhythmia, hypoglycemia, puncture vascular injury, clinical dysuria, hematoma or bleeding, constipation, vague reflex, backache, difficulty sleeping, hypotension, limb pain and other negative effects of the observation group was significantly lower than that of the control group （ P＜0. 05 ） . The incidence rate of blood pressure, blood glucose, abnormal electrocardiogram of the patients of the observation group were significantly lower than that of the control group （ P＜0. 05 ） . The incidence of unsafe factors such as unreasonable exercise, chest tightness after defecate, unreasonable medication, hypoglycemia, low fasting blood glucose, high fast-ing blood glucose, random diet and angina pectoris of the experimental group was lower than that of the control group, and the differences were statistically significant （ P＜0. 05 ） . The score of interventional nursing quality, basic nursing quality and the form-filling quality of nursing of the observation group was significantly higher than that of the control group （P＜0. 05）. The attitude towards service, the postoperative progress of disease, the preoperative health educa-tion, the inform of disease progression, the preoperative health education and overall job evaluation of the observation group were significantly better than that of the control group （ P＜0. 05 ） . Conclusion Nursing-risk management can significantly reduce the risk of the potential surgical injury on patients with coronary heart disease, improve the quality of care and nursing satisfaction. It has a high value of popularization and application.