摘要
目的:探讨建立核心制度关键风险指标对减少不良事件的作用。方法分析2014年度前三季度147起与核心制度执行不合格造成的护理不良事件的末端原因,以及不良事件根本原因构成数据和护士不落实核心制度的高风险环节,建立输液治疗、日班和夜班随机时段的查对制度落实率、医嘱制度落实率、患者识别制度执行合格率,分别由质量管理委员会评价员、病区护士长、护理总值班员监测全院29个护理单元,包括27个病区和ICU、急门诊输液室等。收集指标数据,每季度统计分析并进行针对性改善。结果实施指标管理1年后3项核心制度落实率较实施初期均有明显提高,各关键环节的核心制度执行合格率已达到或接近95%,查对制度执行总合格率较实施前提高了6.94%,医嘱执行制度执行合格率较实施前提高了9.33%,患者识别制度的执行合格率较实施前提高了4.29%,各项合格率变化比较均差异有统计学意义(P<0.05);2年护理不良事件数据比较,实施核心制度关键风险指标管理后,相关不良事件减少11.06%(P<0.05)。结论建立核心制度关键风险指标管理可有效提高核心制度落实率,减少护理不良事件。
Objective To research the effects of establishing core system key risk index in reducing adverse events. Methods Analyzed the causes of the 147 adverse events in 2014. Including the core system implementation of the reasons for the end of the adverse events caused, the data of fundamental reasons in adverse events and the high risk link that because nurses don′t practice the core system. In 2015, randomly checked the 29 nursing units, including 27 wards and emergency outpatient transfusion room, ICU. Contains the implement rates of the core system in transfusion treatment, day and night shifts, doctors′ advice and patients′ identification. In order to quarterly analysis the index and pertinently improve the results, assessors of quality administration council, head nurse in endemic area and attendant watch keeper are chosen to gather index data. Results After one year of management, the key aspects of the core system execution qualified rate has reached 95%, the check of the implementation of the system, the total pass rate compared with before had increased 6.94%, orders execution system implementation of a qualified rate had increased 9.33%, patient identification system implementation of qualified rate had increased 4.29%, the qualified rate of change of comparison the differences were statistically significant (P<0.05). After the establishment of the core system key risk index management, the adverse events had decreased 11.06%(P < 0.05). Conclusion The establishment of the core system key risk index management can effectively improve the implement rates and reduce the nurse adverse events.
出处
《中国实用护理杂志》
2016年第21期-,共5页
Chinese Journal of Practical Nursing