急诊观察室老年危重患者护理危险因素分析及护理策略改良研究措施

Nursing risk factors and improvement of nursing strategies for critically illelderlypatients at emergency observation room

目的分析急诊观察室老年危重患者护理危险因素,并就此提出相应护理改良措施。方法回顾性分析2017年10月至2018年10月本院急诊观察室收治的50例老年危重患者资料,其中有10例(20.0%)患者发生不安全事件,并命名为发生组,未发生不安全事件的40例患者命名为未发生组,采用SPSS20.0和多因素logistic回归模型,分析患者一般资料和相关症状。结果多因素logistic回归模型分析急诊观察室老年危重患者护理危险因素的独立性危险因素包括:患者不遵医嘱(OR:2.598,95%CI:2.381-6.827)、护理人员专业技术不合格(OR:3.404,95%CI:3.401-5.729)、缺乏沟通(OR:3.539,95%CI:2.918-6.801)及疲劳(OR:3.698,95%CI:2.895-7.165)。结论急诊观察室的老年危重患者可由于患者不遵医嘱和护理人员专业技术不合格、缺乏沟通及疲劳因素导致发生护理危险不安全事件,因此,应加强专业技术管理和改良弹性工作制度,提高护理人员对本职工作的责任心和职业操守。

Objective To analyze the nursing risk factors ofcritical ill elderlypatients at emergency observation room, and to put forwardthe corresponding nursing improvement measures.Methods We retrospectively analyzed the data of 50critically ill elderlypatients admitted to the emergency observation room at our hospital from October, 2017 to October, 2018. Among them, 10 patients (20.0%) had unsafe events, andwere named as an occurrence group;and the other 40 patients were named a non-occurrence group. The general data and related symptoms were analyzed by SPSS20.0 and multivariate logistic regression model.ResultsMultivariate logistic regression model was used to analyze the independent risk factors of nursing risk factors for criticallyill elderly patients at emergency observation room. The nursing risk factors were as follow: the patients failed to comply with doctor's instructions (OR:2.598,95%CI:2.381-6.827);the nurses were not qualified in professional skills (OR:3.404,95%CI:3.401-5.729);lack of communication (OR:3.539,95%CI:2.918-6.801);and fatigue (OR:3.698,95%CI:2.895-7.165).Conclusions Emergency observation is thatcriticallyill elderlypatients may suffer from unsafe nursing events due to patients' failure to comply with doctors' instructions and unqualified professional skills of nursing staff, lack of communication, and fatigue. The professional management and flexible work system should be strengthened, and the sense of responsibility and professional conduct of nursing staff should be improved.