基于结构化管理的护理安全策略干预在额叶胶质瘤晚期危重患者医源性皮肤损伤防治中的应用效果分析

Effect of Structured Management-based Nursing Safety Strategy Intervention on the Prevention and Treatment of Iatrogenic Skin Injury in Critical Patients with Advanced Frontal Lobe Glioma

目的:探讨基于结构化管理的护理安全策略干预在额叶胶质瘤晚期危重患者医源性皮肤损伤防治中的应用效果。方法:选取2016年1月—2019年9月郑州大学第一附属医院住院治疗的60例额叶胶质瘤晚期危重患者作为研究对象,按照护理方法不同分为对照组和观察组,每组各30例。对照组实施常规护理,观察组实施基于结构化管理的护理安全策略干预。比较两组患者危象发生及功能恢复情况、医源性皮肤损伤、护理质量、护理纠纷和投诉情况。结果:两组患者治疗后颅内高压、肺感染高热、昏迷等危象发生情况及功能恢复等级比较,差异无统计学意义(P>0.05)。观察组医源性皮肤损伤发生率为20.00%,明显低于对照组的40.00%,差异有统计学意义(χ^(2)=9.345,P<0.05)。观察组护理人员技术操作、护理记录、护理安全管理、业务考核及护理质量评分均明显高于对照组护理人员,差异有统计学意义(t=14.935、11.230、24.204、13.267、24.386,P<0.05)。两组患者护理纠纷发生率比较,差异无统计学意义(χ^(2)=1.525,P>0.05);观察组投诉率明显低于对照组,差异有统计学意义(χ^(2)=15.752,P<0.05)。结论:基于结构化管理的护理安全策略干预,可有效降低额叶胶质瘤晚期危重患者医源性皮肤损伤的发生,提高医护人员的护理质量,减少医患纠纷和投诉的发生。

Objective:To explore the analysis of the effectiveness of a structured management-based nursing safety strategy in⁃tervention applied to the prevention and treatment of medically induced skin injury in critically ill patients with advanced frontal glioma.Methods:60 cases of critically ill patients with advanced frontal glioma hospitalized from January 2016 to September 2019 were selected as study subjects and divided into control group and observation group according to different care methods,with 30 cases in each group.The control group implemented conventional care and the observation group implemented a nursing safety strategy intervention based on structured management.The occurrence of critical signs and functional recovery,medically induced skin injury,quality of care,nursing disputes and complaints were compared between the two groups.Results:There was no statisti⁃cally significant difference between the two groups in the occurrence of intracranial hypertension,pulmonary infection hyperther⁃mia,coma and other critical signs and functional recovery grade after treatment(P>0.05).The incidence of medically induced skin injury in the observation group was 20.00%,which was significantly lower than 40.00%in the control group,and the difference was statistically significant(χ^(2)=9.345,P<0.05).The technical operation,nursing records,nursing safety management,operational assessment and nursing quality scores of nursing staff in the observation group were significantly higher than those of nursing staff in the control group,with statistically significant differences(t=14.935,11.230,24.204,13.267,24.386,P<0.05).The difference in the incidence of nursing disputes between the two groups was not statistically significant(χ^(2)=1.525,P>0.05).The complaint rate of the observation group was significantly lower than that of the control group,and the difference was statistical⁃ly significant(χ^(2)=15.752,P<0.05).Conclusion:A structured management-based nursing safety strategy intervention can effective⁃ly reduce the occurrence of medically induced skin injuries in critically ill patients with advanced frontal lobe glioma,improve the quality of nursing care,and reduce the occurrence of doctor-patient disputes and complaints.