急诊突发事件4R危机管理应急反应体系的构建与实践

The construction and practice of 4R crisis management of emergency response system in emergency incidents

目的构建急诊突发事件4R危机管理应急反应体系，以提高急诊护理人员应急反应及风险规避能力，确保患者安全。方法引入4R危机管理理论，构建急诊突发事件“以危机缩减降低应急风险为前提、以危机预备抵制应急风险为保障、以危机反应规避应急风险为手段、以危机恢复持续优化应急管理为目标”的动态应急反应体系，比较构建应急反应体系前后急诊护理人员应急反应能力及规避纠纷能力。结果构建急诊突发事件4R危机管理应急反应体系前后急诊护理人员应急能力、沟通能力、解决问题的能力等得到提升，应急反应能力从（86．91±5．98）分提高到（93．06±1．94）分（P〈0．01），差异有统计学意义；规避纠纷能力从（83．95±2．99）分提高到（94．11±0．87）分（P〈0．01），差异有统计学意义。结论构建急诊突发事件4R危机管理应急反应体系，能有效提升急诊护理人员应急反应能力和规避纠纷的能力，确保患者安全。

Objective To improve the ability of emergency response and risk aversion in emergency incidents, the 4R crisis management of emergency response was built. Methods The theory of 4R crisis management was conducted to construct dynamic emergency response system in emergency incidents. The goal of 4R crisis management system was to decrease the risks of crisis at the most, The methods was to set up a risk avoid system. Continuously optimizing the recovery ability after crisis was the target. After 4R crisis dynamic management of emergency response system for emergency incidents was constructed,the ability of emergency response and avoidance of dispute before and after the construction were compared with each other. Results The abilities of emergency response, problem-solving, and communication skills were improved in the emergency incidents after the construction of 4R crisis management of emergency response system. The ability of emergency response was improved from 86.91±5.98 to 93.06± 1.94 （P〈 0.01 ）, avoidance of dispute was improved from 83.95±2.99 to 94,11 ±0.87 （P 〈 0.01 ）. Conclusion The construction of 4R crisis management of emergency response system in emergency present a great efficiency in improving the ability of emergency response and avoidance of dispute. And patient＇s safety was guaranteed successfully.