急诊不同护理单元工作中断事件的比较分析

Comparative analysis of nursing interruption in different units of emergency department

目的:比较急诊不同护理单元护理中断事件核心要素的差异,并提出干预策略。方法:调查2019年8月—2019年11月成都市某三级甲等综合医院急诊抢救区、观察室和急诊重症监护室(EICU)所发生的护理中断事件,比较分析3个护理单元护理中断事件核心要素的差异。结果:抢救区、观察室、EICU护理中断事件发生频率依次为每小时6.1次、5.3次、4.7次;抢救区与观察室护理中断来源以病人及家属为主(30.0%、42.2%),EICU多源自护士(36.8%);3个急诊单元中断类型均以侵扰型为主;当前事务方面,抢救区以观察与记录为主(44.7%),观察室与EICU为治疗性护理为主(39.7%、38.8%);中断结局均以消极型结局为主,中断处理措施均以立即中断为主。3个急诊护理单元护理中断核心要素总体分布比较差异有统计学意义(P<0.05)。结论:急诊科抢救区、观察室、EICU护理中断事件发生频率均处于中等水平,护理中断核心要素存在差异,建议采取干预策略以减少急诊护理过程中不必要的中断,从而提高护理质量,保证病人安全。

Objective:To compare the differences in the core elements of nursing interruption events in different nursing units in the emergency department,and propose intervention strategies.Methods:To observe the interruption of nursing care that occurred in the emergency room,observation room and EICU of a tertiary grade A hospital in Chengdu from August 2019 to November 2019,and compare and analyze the differences in the core elements of the interruption events of the three nursing units.Results:The frequency of nursing interruption events in the emergency room,observation room and EICU were 6.1 times,5.3 times and 4.7 times per hour respectively.Patients and their families were the main sources of nursing interruption in the emergency room and observation room(30.0%,42.2%),and nurses were the main source of EICU(36.8%).Interruption type three emergency units were mainly intrusive type.In terms of current affairs,observation and recording were the main care in the rescue area(44.7%),and observation room and EICU were the therapeutic care(39.7%,38.8%).The interruption outcomes were mainly negative outcomes;the interruption treatment measures were all based on immediate interruption.The differences in the overall distribution of core elements of nursing interruption in the three emergency care units were statistically significant(P<0.05).Conclusion:The frequency of nursing interruption events in the emergency room,observation room,and EICU were all at a moderate level.The core elements of nursing interruption were different.Intervention strategies are recommended to reduce unnecessary interruptions in emergency care to improve the quality of care and ensure patient safety.