神经内科走失风险评估联合制度化管理的实施

Implementation of Loss Risk Assessment Combined with Institutionalized Management in Department of Neurology

目的探讨实施走失风险评估联合走失高危患者的制度化管理对预防神经内科住院患者走失的效果。方法将2018年1—12月收治的1332例患者作为研究对象(观察组),按自行设计的《住院患者走失风险系数评估表》进行走失风险评估,按照神经内科疾病护理常规进行护理,实行责任制护理,同时根据走失高危患者的管理制度进行患者住院期间的全程管理,其中包括走失风险系数的动态评估、住院患者预防走失告知书的签署、走失高危患者规范化护理措施的实施、住院患者走失紧急预案的定期演练。另将2017年1—12月收治的1210例未进行走失风险系数的动态评估患者作为对照组。比较2组走失高危患者的走失发生率。结果应用走失风险评估量表及实施走失高危患者制度化管理方案1年后,观察组走失高危患者52例,走失不良事件发生率为1.92%(1/52);对照组走失高危患者48例,走失不良事件发生率为10.42%(5/48),2组比较差异有统计学意义(χ^2=5.151,P<0.05)。结论开展走失风险评估联合走失高危患者的制度化管理能有效预防神经内科住院患者走失事件的发生,确保患者的住院安全。

Objective To explore the efficacy of loss risk assessment combined with institutionalized management in the prevention of loss in patients hospitalized in the department of neurology.Methods A total of 1332 patients admitted from January to December 2018 were selected as the research objects(observation group),and the risk of loss was assessed according to the self-designed“risk coefficient assessment form for inpatients”.The patients received routine care and institutionalized management.Simultaneously,the patients were given whole-process management according to the management system of loss high-risk patients,including dynamic assessment of loss risk coefficient,signing of notification of inpatient loss prevention,implementation of standardized nursing measures for loss high-risk patients,and regular exercise of emergency plan for inpatient loss.In addition,1210 patients admitted from January to December 2017 who did not receive dynamic assessment of loss risk coefficient were selected as the control group.The incidence of loss among high-risk patients was compared between the two groups.Results One year after the implementation of loss risk assessment and institutionalized management,there were 52 lost high-risk patients in the observation group and 48 lost high-risk patients in the control group.The incidence of loss-related adverse events in the observation group(1.92%,1/52)was lower than that in the control group(10.42%,5/48)(χ^2=5.151,P<0.05).Conclusion The risk assessment of loss and institutionalized management of high-risk patients can effectively prevent the occurrence of loss in the department of neurology and ensure the safety of patients in hospital.