摘要
目的 :运用全面触发工具(Global Trigger Tool,GTT)对住院患者的护理不良事件进行监测,评估该工具识别护理不良事件的可行性和潜力。方法 :通过回顾性横断面调查,采用系统抽样的方式抽取某三级甲等医院2020年6月1日至2021年5月31日期间出院的600例成人住院患者的病历信息,使用GTT中14项护理相关触发器对病历进行查阅,确定护理不良事件并对其进行严重程度分级,评价GTT在提高护理不良事件检出率方面的优势。结果 :600份病历中,14项触发器阳性触发率均为100.0%,阳性触发总频次为237次,阳性检出频次为41次,触发器阳性预测值为17.3%,600份病历中共筛选出44个护理不良事件,护理不良事件发生率为7.3%,GTT检出率为5.0%,自愿上报率为1.5%。在GTT检出的护理不良事件中,导致暂时性伤害,需要采取干预措施(E类)为16例(2.7%);暂时性伤害,需要住院治疗或延长住院时间(F类)为14例(2.3%)。结论 :GTT对护理不良事件的主动监测具有积极的作用,可有效监测成年住院患者护理不良事件发生情况,以便医疗机构对护理不良事件的发生情况进行统计并分析,对于高风险流程的主动分析是一个有价值的补充,对我国临床具有一定的借鉴意义,但GTT还需要经过进一步修订,以适用于各医疗机构对护理不良事件的监测。
Objective: The aim of the study was to evaluate the feasibility and potential of the Global Trigger Tool(GTT) for identifying Adverse Nursing Events(ANEs) in hospital. Methods: By retrospective cross-sectional survey method and systematic sampling, a total of 600 adult patient records were selected from a tertiary grade A hospital from June 1,2020 to May 31, 2021. Totally 14 nursing-related triggers in GTT were used to check the medical records, determine ANEs and conduct a severity level, and evaluate the advantages of GTT to increase ANEs detection rate. Results: Among the 600 medical records, the positive trigger rates of 14 triggers were 100.0%, and the total frequency of positive trigger was 237 times. The positive detection frequency was 41 times, and the Positive Predictive Value of triggers was 17.3%, ANEs incidence was 7.3%, GTT detection rate was 5.0%, the voluntary reporting rate was 1.5%. A total of 2.7% of all identified ANEs resulted in temporary harm(category E), 2.3% in temporary harm, requiring prolonged hospitalization(category F). Conclusion: The application of the GTT can effectively monitor the occurrence of ANEs in adult hospitalized patients,in order to facilitate the statistics and analysis of the occurrence of ANEs in medical institutions, the trigger detection with the GTT is a valuable addition for proactive analyses of high-risk processes. But the GTT needs to be further revised to be applicable to the monitoring of ANEs in various medical institutions.
作者
王渟
谭春燕
李冬雪
周小兰
唐佳
孔维娜
WANG Ting;TAN Chunyan;LI Dongxue;ZHOU Xiaolan;TANG Jia;KONG Weina(Nursing Department,Chengdu University of Traditional Chinese Medicine,Chengdu,610000,China)
出处
《中国护理管理》
CSCD
2022年第10期1530-1533,共4页
Chinese Nursing Management
基金
重庆医科大学附属第二医院“宽仁英才”项目(重医二院党[2020]7号)。
关键词
护理不良事件
全面触发工具
主动监测
病历审核
Adverse Nursing Events
Global Trigger Tool
active monitoring
record review