住院患者胃管非计划拔管的数据挖掘及防范对策分析

Data mining and preventive countermeasure analysis of unplanned extubation of gastric tube in hospitalized patients

目的挖掘住院患者胃管非计划拔管数据中有价值的关联规则,为预防非计划拔管提供参考依据。方法收集2018年1月-2020年12月浙江省某三级甲等医院2个院区746例胃管非计划拔管事件的相关信息,采用Apriori算法进行数据挖掘,使用卡方检验分别对得到的关联规则进行有效性评定。结果共发现637条胃管非计划拔管事件关联规则,经卡方检验筛选出225条规则,最终筛选出10条具有临床实际指导意义的强关联规则,包括患者意识、年龄≥60岁、置管1~7 d、未使用约束带、因置管带来的不适感等。结论在护理工作中需提炼胃管非计划拔管风险评估要点,关注重新置管预测因素和患者不适症状,鼓励患者说出真实感受,夜间有效巡视,实施分时段人性化保护性约束,减少胃管非计划拔管的发生。

Objective To find out the valuable association rules in the data of inpatients with unplanned gastric tube extubation,and provide reference for the prevention of unplanned gastric tube extubation.Methods Collected information about 746 cases of unplanned extubation of gastric tube in 2 districts of Grade I,Grade A hospitals in Zhejiang Province from January 2018 to December 2020,and used Apriori algorithm for data mining,then used the chi-square test to evaluate the validity of the obtained association rules respectively.Results A total of 637 association rules were found and then 225 rules were screened out by the chi-square test,and 10 strong association rules with clinical practical guiding significance were finally screened out.Rules included patient awareness,age≥60 years old,catheter placement for 1~7 days,no restraint bands discomfort caused by catheter placement,etc.Conclusion It is necessary to refine the key risk assessment points of unplanned extubation of gastric tube,focus on the predictive factors of reinsertion and discomfort symptoms of patients,encourage patients to talk about their true feelings.conduct effective night patrols,implement time-based humanized protective restraint to reduce the occurrence of unplanned extubation of the gastric tube.