根因分析法在急救护理不良事件中的应用价值

The application value of root cause analysis in adverse events of emergency nursing care

目的探讨根因分析法在预防急救病例中护理不良事件的应用价值。方法比较根因分析实施前(2016年4月—2017年4月)和实施后(2017年5月—2018年4月),我院急救病例中护理不良事件的发生及上报情况。依据根因分析法,对实施前护理不良事件的统计资料进行分析,针对不良事件的产生原因制定相应的整改措施,观察实施根因分析后急救病例中护理不良事件的发生率及上报率的变化。同时观察整改前后护理人员工作满意度和护患纠纷的发生率,分析差异原因。结果根因分析法实施之后急救护理的不良事件发生率明显降低,不良事件上报率较同期显著上升,整改前、后比较差异具有统计学意义(P <0. 05);护理人员满意度较整改前显著提高(P <0. 05),而护患纠纷发生率明显低于整改前(P <0. 05)。结论根因分析法的应用有利于降低临床急救病例的护理不良事件发生率,同时,可以提高急诊护理人员的满意度,增强护患之间的合作度,有效预防护患纠纷的发生率,值得进一步研究。

Objective ： To explore the application value of root cause analysis in preventing adverse events in emergency eases. Methods ： The occurrence of nursing adverse events in the first aid eases of our hospital was compared with the implementation of the root cause analysis （ April 2016 to April 2017） and the implementation （ May 2017 to April 2018 ）. Before the implementation of returning for analysis, based on the statistical data of nursing adverse events analysis, in view of the causes of the adverse events, formulate corresponding corrective actions, observing the implementation of returning after the analysis of the occurrence of nursing adverse events in emergency eases. At the same time, observe the nursing staff＇s job satisfaction and the incidence of nursing dispute before and after the rectification. Results ： The implementation of returning for analysis, the rectification after care significantly lower incidence of adverse events, a marked increase in the rate of adverse events reported during this period, compared with before the rectification differences statistically significant （P 〈 0. 05 ） ; The satisfaction degree of nursing staff was significantly improved before the rectification （ P 〈 0. 05 ）, while the incidence of nursing dispute was significantly lower than that before the rectification （ P 〈 0. 05 ）. Conclusion ： The application of the returning analysis is helpful to reduce the incidence of clinical emergency eases of nursing adverse events, at the same time, can improve the satisfaction of emergency nursing staff, improve the degree of collaboration between nurses and patients, to reduce the dispute of nurses and patients, deserves further research.