应用医疗团队资源管理模式进行呼吸科用药护理中断事件的研究实践

Practical research on the application of medical team resource management model to the interruption of medication nursing in the department of respiratory medicine

目的探讨应用医疗团队资源管理模式进行呼吸科用药护理中断事件的管理效果。方法选取我院呼吸科护士作为研究对象,采用非同期对照法,观察用药高峰工作时段(上午09:00~11:00)呼吸科12名护士在病区进行用药护理时中断事件的发生情况。干预前实施预防用药中断一般指导,在应用医疗团队资源管理模式实施全程护理干预后,比较干预前、后护理中断事件发生的频率、环节、类型、护士认知及依从性方面的差异。结果干预后用药护理中断事件发生频率较干预前减少;在床边静脉输液治疗、口服药发放、护士站查对用药医嘱3个中断环节干预前后比较,差异有统计学意义(P<0.05);矛盾型、毁损型2种类型的用药护理中断发生频率降低;护士对中断事件认知水平优良率高于干预前(P<0.05)。结论应用医疗团队资源管理模式能有效降低呼吸科用药护理中断事件发生频率,提高护士对中断事件认知水平和应对能力,促进临床的护理安全管理。

Objective To explore the effect of application of medical team resource management mode to the interruption of medication nursing in the department of respiratory medicine.Methods The nurses from the department of respiratory medicine in our hospital were selected as research subjects,and the non-synchronous control method was used to observe the occurrence of interruption events when twelve respiratory nurses were carrying out medication care in the ward during the peak hours of drug administration(09:00-11:00a.m.).General guidance on prevention of medication interruption was implemented before the intervention.After the wholecourse nursing intervention was implemented through the medical team resource management mode,differences in the frequency,links,types,nurses'cognition and compliance of nursing interruption events between before and after the intervention were compared.Results The occurrence frequency of medication nursing interruption events after intervention was lower than that before intervention.The difference was statistically significant(P<0.05)between before and after the intervention in the three interruption links of bedside intravenous infusion therapy,oral medication delivery and nurse station check of medication orders.The occurrence frequency of the contradictory and destructive types of interruption of medication nursing decreased.The superior rate of nurses'cognition of interruption events was higher than that before intervention(P<0.05).Conclusion The application of medical team resource management mode can effectively reduce the occurrence frequency of interruption of medication nursing in the department of respiratory medicine,improve nurses'cognitive level and coping ability in interruption events,and promote clinical nursing safety management.