心内科住院患者离院外出的原因分析及护理对策

Cause Analysis of Leaving Hospital and Nursing Strategy in Cardiology Department Inpatients

目的探讨心内科住院患者离院外出的原因及护理对策。方法采用自行设计的一般资料调查表对我院心内科2017年7月~2018年7月103例住院期间离院不归患者进行问卷调查和访谈,并对住院患者离院不归发生的不良事件进行讨论分析,提出具有针对性的护理对策。结果共103例心内科住院离院外出患者,男性多于女性,其中>60岁、已婚、小学及以下学历、非独居以及退休患者居多。共发生4件不良事件,其中1例发生外用过期药物致过敏性休克、房颤患者血栓脱落致脑卒中,1例发生跌倒致擦伤或扭伤。离院原因主要以角色的适应与转换为首位,其次为对疾病的危险性认识不足、住院保养患者,忽视医院规章制度、居住地离医院较近、医院环境因素、医护人员对患者健康宣教欠缺。结论心内科住院离院外出患者中男性多于女性,主要离院原因为角色的适应与转换。在入院时综合评估患者的个体、家庭等因素,根据患者不同离院原因,采取相应护理措施,最大程度杜绝患者离院现象,避免不良事件发生。

Objective To investigate the causes and nursing strategies of outpatients in hospital for cardiology.Methods A self-designed general data questionnaire was used to conduct a questionnaire survey and interviews with 103 patients who were hospitalized during the hospitalization period from July 2017 to July 2018 in our department of cardiology, and adverse events occurred in hospitalized patients who were discharged from hospital. Conduct discussion and analysis and propose targeted nursing strategies.Results A total of 103 patients with cardiology were hospitalized out of hospital, more men than women, including >60 years old, married, primary school and below, non-indigenous and retired patients. A total of 4 adverse events occurred, including 1 cases of anaphylactic shock caused by topical expired drugs, stroke caused by thrombus in patients with atrial fibrillation, and 1 cases of falls causing bruises or sprains. The reasons for leaving the hospital are mainly the adaptation and transformation of the role, followed by insufficient understanding of the risk of the disease, hospitalization and maintenance of patients, neglect of hospital rules and regulations, close proximity to the hospital, hospital environmental factors, medical staff lack of health education for patients.Conclusion There are more males than females in the outpatients who are hospitalized in the Department of Cardiology. The main reason for leaving the hospital is the adaptation and transformation of roles. At the time of admission, the patient's individual and family factors were comprehensively evaluated. According to the patient's different reasons for leaving the hospital, corresponding nursing measures were taken to minimize the patient's leaving the hospital and avoid adverse events.