基于综合安全文化改进模式护理在老年肿瘤患者跌倒坠床风险控制中的应用效果

Application effect of comprehensive unit-based safety program in reducing the risk of fall out of bed in elderly cancer patients

目的探讨单元综合安全文化改进项目(CUSP)在降低老年肿瘤患者跌倒坠床发生风险、提升质量改进实效、创新安全文化实践中的应用价值。方法选取该院2020年1月至2020年12月收治的高危老年跌倒坠床患者93例,将2020年1~6月的患者作为对照组(41例),实施院内跌倒坠床常规预防处理措施;将2020年6~12月的患者作为观察组(52例),在CUSP模式指导下实施跌倒坠床的安全文化干预措施。比较后单元内医护人员的安全文化水平、医护人员在跌倒坠床相关知识掌握、高危因素评估能力、沟通协调能力、安全措施落实能力等方面的效果以及两组患者跌倒坠床发生率。结果干预后医护人员的安全文化认同水平在对"错误的反馈与沟通""组织学习及持续改进""科室间协作""对错误的非惩罚性反应""对患者安全的整体感觉""不良事件上报频率"6个维度上明显高于干预前,差异有统计学意义(P<0.05);干预后医护人员在"高危因素评估能力""沟通协调能力""安全措施落实能力水平"显著高于干预前,差异有统计学意义(P<0.05);观察组科室跌倒坠床发生率低于对照组,差异有统计学意义(P<0.05)。结论CUSP在有效预防老年肿瘤患者跌倒坠床发生、提高科室整体安全文化水平方面具有显著作用,可以为改进医疗质量安全提供方法上的借鉴作用。

Objective To explore the application value of comprehensive unit-based safety program(CUSP)in reducing the risk of fall out of bed,improving the effectiveness of quality improvement and innovating the practical tools of safety culture.Methods A total of 93 patients with high risk of falls and fall out of bed were collected from January 2020 to December 2020.The patients from January to June 2020 were selected as the control group(41 cases),and the routine preventive treatment measures of falling in hospital were implemented.Patients from June to December 2020 were selected as the observation group(52 cases)to implement the safety culture intervention measures for falling down under the guidance of CUSP mode.The safety literacy level of medical staff in the unit,the effects of medical staff on the knowledge of falls and fall out of bed,the evaluation ability of high-risk factors,the communication and coordination ability,the ability to implement safety measures and other aspects,as well as the incidence of falls and fall out of bed of the two groups of patients were compared.Results After the intervention,the safety of the staff level of cultural identity on the"wrong feedback and communication","organizational learning,and continuous improvement","collaboration between departments","response to the error of punitive","the overall feeling of patient safety","frequency of adverse events reported"six dimensions were significantly higher than before intervention,and the differences were statistically significant(P<0.05).After intervention,the"high risk factor assessment ability","communication and coordination ability"and"safety measure implementation ability level"of medical staff were significantly higher than before intervention,and the differences were statistically significant(P<0.05).The incidence of falls in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions CUSP plays a significant role in effectively preventing the occurrence of falls and fallout of bed in elderly cancer patients and improving the overall safety culture level of the department,which can provide a reference for improving the quality and safety of medical treatment.