200例护理不良事件调查分析

Investigation and analysis of 200 cases of nursing adverse events

目的:探讨分析200例护理不良事件情况,并提出相应策略。方法:选取2015年2月~2016年2月我院上报的200例护理不良事件进行回顾性研究分析,根据护理不良事件的基础、护理质量指标及严重程度进行分析,对发生的护理不良事件进行统计分类,并探讨相应的整改对策。结果:护理不良事件发生例数从高至低排列前3位的分别为非计划性拔管、职业暴露、坠床及跌倒,所占比例分别为28.50%,24.00%,19.00%;护理不良事件各片区分布以大内科、大外科为主,所占比例分别为50.50%、35.50%;护理不良事件发生时间主要为早晨、下午以及凌晨,所占比例分别为29.00%,24.00%,20.00%;护理不良事件发生涉及的护理人员职称多为护士(80.50%),护生(13.50%),入职工龄多为1~3年;按照严重程度可分为2例警告事件、109例不良事件、74例未造成后果事件、15例隐患事件。结论:在医院护理工作过程中,应学会合理运用各项护理质量指标,对护理管理程序进行优化,以减少护理不良事件发生,提高医疗服务的安全性。

Objective：To analyze and explore 200 cases of nursing adverse events and to put forward the corresponding strategy.Methods：A total of 200 cases of nursing adverse events in our hospital from February 2015 to February 2016 were analyzed retrospectively.According to the basis of nursing adverse events,nursing quality index and severity,the adverse events were statistically classified and the corresponding rectification measures were explored.Results：The ranking number of cases of nursing adverse events from the highest to the top were non-planned extubation,occupational exposure as well as falling down from the bed and falling,with the proportion of 28.50%,24.00% and 19.00%.The areas where nursing adverse events happened mainly located in general medicine and major surgery,with the proportion of 50.50% and 35.50%.The time of nursing adverse events main occurred in morning,afternoon and at dawn,with the proportion of 29.00%,24.00% and 20.00%.The relevant nursing staff in the adverse events were nurses（ 80.50%） and nursing students（ 13.50%） with working length for more than 1 to 3 years.According to the severity of the events,these adverse events could be divided into two cases of warning events,109 cases of adverse events,74 cases without consequences as well as 15 cases of hidden dangers.Conclusion：In the course of hospital nursing work,we should learn the rational use of nursing quality indicators and optimize the nursing management procedures to reduce the occurrence of nursing adverse events and improve the safety of medical services.