基于风险评估管理模型的神经外科危重患者床旁监护仪安全管理研究

Study on the safety management of bedside monitors for critically ill patients in neurosurgery department based on risk assessment management model

目的:基于风险评估管理模型构建床旁监护仪风险管理体系,分析其在神经外科危重患者临床管理中的应用价值。方法:基于风险评估管理模型筛选失效风险指标,构建床旁监护仪风险管理体系。选取2021年12月至2022年12月空军军医大学第一附属医院收治的150例神经外科危重症患者,采用随机数表法将其分为对照组和观察组,每组75例,两组患者住院期间30名责任护士参与临床护理,16台多功能床旁监护仪用于监测患者生命体征,对照组行常规护理管理干预,观察组在常规护理干预基础上,采用基于风险评估管理模型的床旁监护仪风险管理体系开展风险评估管理。对比两组患者监护质量评分、设备管理质量评分和责任护士能力评分的差异。结果:观察组患者的呼吸、血压、血氧饱和度和心电图监护质量平均评分分别为(37.52±0.26)分、(36.61±1.29)分、(36.56±2.57)分和(38.25±0.56)分,均高于对照组,差异有统计学意义(t=43.925、33.150、13.655、32.035,P<0.05);观察组床旁监护仪性能控制质量和运行质量平均评分分别为(95.43±0.46)分和(96.51±0.77)分,均高于对照组,差异有统计学意义(t=70.976、35.439,P<0.05);观察组护士设备操作能力、设备认知能力和设备报警管理能力平均评分分别为(9.43±0.25)分、(8.56±0.64)分和(9.25±0.24)分,均高于对照组,差异有统计学意义(t=92.952、24.455、58.024,P<0.05)。结论:基于风险评估管理模型的床旁监护仪风险管理体系的应用,能够实现对神经外科危重患者床旁监护仪的高效管理,在保障患者生命安全的基础上,提高设备运行效率和质量。

Objective:To establish a risk management system of bedside monitor based on risk assessment management model,and to analyze its application value in the clinical management of critically ill patients in neurosurgery department.Methods:Based on the risk assessment management model,the failure risk index was screened,and the risk management system of bedside monitor was established.A total of 150 critically ill neurosurgical patients admitted to The First Affiliated Hospital of Air Force Medical University from December 2021 to December 2022 were selected and divided into control group and observation group by random number table method,with 75 cases in each group.During the hospitalization of the two groups of patients,30 responsible nurses participated in clinical care,and 16 multifunctional bedside monitors were used to monitor patients'vital signs.The control group received routine nursing management intervention.On the basis of routine nursing intervention,the observation group carried out risk assessment management based on the risk assessment management model of bedside monitor risk management system.The differences in patient monitoring quality score,equipment management quality score and responsible nurse ability score were compared between the two groups.Results:The average scores of respiration,blood pressure,blood oxygen saturation and ECG monitoring quality of the patients in observation group were(37.52±0.26)points,(36.61±1.29)points,(36.56±2.57)points and(38.25±0.56)points,respectively,which were higher than those in control group,the difference was statistically significant(t=43.925,33.150,13.655,32.035,P<0.05).The average scores of performance control quality and operation quality of bedside monitor in the observation group were(95.43±0.46)points and(96.51±0.77)points,respectively,which were higher than those in control group,the difference was statistically significant(t=70.976,35.439,P<0.05).The average scores of nurses in terms of ability of equipment collaboration,equipment use mastery and equipment alarm management in the observation group were(9.43±0.25)points,(8.56±0.64)points and(9.25±0.24)points,respectively,which were higher than those in the control group,the differences were statistically significant(t=92.952,24.455,58.024,P<0.05).Conclusion:The bedside monitor risk management system based on the risk assessment management model can realize the efficient management of bedside monitors for critically ill neurosurgical patients,and improve the operating efficiency and quality of the equipment on the basis of ensuring the life safety of patients.