基于澳新风险管理标准的社区老年病房风险管理体系构建与应用

Construction and application of community geriatric ward risk management system based on Australia and New Zealand risk management standards

目的基于澳新风险管理标准构建社区卫生服务中心老年病房风险管理体系,并对实施和应用效果进行评价。方法按照澳新风险管理标准建立老年病房风险管理体系,制定组织架构和岗位职责,建立风险管理的目标、环境、识别、分析、评价和控制等制度体系;运用风险量化矩阵的工具,通过风险类型、风险描述、现有控制措施、最初后果、最初发生可能性、最初风险评分、增加其他控制措施、剩余后果、剩余可能性、剩余风险评估等方式评价社区老年病房的风险。结果通过江川社区卫生服务中心院部统计数据显示,2019年全年全院上报老年病房不良事件63起,前5位高频发或后果严重的事件为疥疮(18起)、压疮(13起)、跌倒(8起)、猝死(7起)、轻生事件(4起),均属于患者服务与安全风险,故将社区老年病房的疥疮、压疮、跌倒、猝死、轻生作为5个重要风险点。运用风险管理体系,通过风险量化矩阵的工具,对5个重要风险点进行评估,结果分别为16、15、12、10、10分。采用PDCA管理循环模型做好风险控制的落实与实施,再运用风险量化矩阵工具评估5个重要风险点的剩余风险,分别为8、12、9、5、5分。结论基于澳新风险管理标准构建社区卫生服务中心老年病房风险管理体系能够达到对风险的预防和控制,是一个能有效控制老年病房风险的管理工具,值得学习和推广。

Objective On the basis of the Australia and New Zealand(ANZ)risk management standard,a risk management system for the geriatric ward in community health service centre was constructed,implemented,applied and evaluated.Methods According to the ANZ risk management standard,risk management system of geriatric ward was established,organisational structure and post responsibilities were established,the target,environment,appraisal,analysis,evaluation and control system of risk management were planned.Using the tools of risk quantification matrix,the risk of community geriatric ward was evaluated through risk type,risk description,existing control measures,initial consequences,initial occurrence possibility,initial risk score Increase other control measures,residual consequences,residual possibility and other ways.Results According to the statistics of the hospital and the department in 2019,63 adverse events were reported in the geriatric ward throughout the hospital.The top five events with high frequency or serious consequences were scabies(18 cases),pressure sores(13 cases),falls(8 cases),sudden death(7 cases)and suicide events(4 cases).Therefore,scabies,pressure sores,falls,sudden deaths and suicides in community geriatric wards were regarded as five important risk points.Using the risk management system and the tools of the risk quantification matrix,the five important risk points were evaluated,which had a score of 16,15,12,10 and 10 points,respectively.The PDCA management cycle model was used to implement risk control,and then the residual risk was evaluated as 8,12,9,5 and 5 points,respectively.Conclusion The risk management system of geriatric ward in community health service center based on ANZ risk management standards can achieve risk prevention and control.It is a management tool that can effectively control the risk of geriatric ward,which is worthy of learning and promotion.