急诊重症监护室构建患者安全文化的实践与成效  

Practice and effect of building patient safety culture in EICU

作　　者：石群[1] 刘辉[1] 勾洋[1] 

机构地区：[1]北京积水潭医院内科急诊,100035

出　　处：《中华现代护理杂志》2012年第35期4290-4293,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨急诊重症监护室（EICU）构建患者安全文化的成效。方法通过识别护理风险，建立非惩罚性护理不良事件上报制度，建立学习型组织及护患之间有效地沟通交流，并鼓励患者及家属参与来构建患者安全文化。比较构建患者安全文化前后部分护理质量指标及护理缺陷的情况。结果构建患者安全文化后护理文件、护理操作、仪器操作、压疮管理合格率和患者满意度均较构建前明显提高（94．6％比83．2％，96．2％比88．7％，99．0％比91．2％，97．3％比86．6％，98．6％比91．5％），差异有统计学意义（X^2值分别为6．58，4．03，4．96，7．73，3．95；P均〈0．05）。构建患者安全文化后护理事故、护患纠纷、一般护理差错明显减少，分别为：0与1件、1与4件、2与10件，护理不良事件主动报告情况明显增加（14与3件）。结论通过在EICU构建安全文化，护士的安全意识增强，对护理风险的识别与防范能力提高，从而提高了护理质量，保障了患者安全。Objective To discuss the effect of building patient safety culture in E1CU. Methods A non-punitive reporting system of nursing adverse events was set up by identifying nursing risks, a learning organization and effective communication were established, and patients and families were also encouraged to participate in building patient safety culture. Some indicators of nursing quality and nursing defects were compared before and after. Results After building patient safety culture, the qualified rate of nursing documentation, nursing operation, instrument operation and pressure sore management as well as the satisfaction degree of patients improved obviously （94.6% vs 83.2% ,96.2% vs 88.7% ,99.0% vs 91.2% ,97.3% vs 86.6% ,98.6% vs 91.5%, respectively）, and the differences were statistically significant （ X2 = 6.58,4.03, 4.96,7.73,3.95, respectively; P 〈 0.05 ）. Nursing accidents, nurse-patient conflicts and nursing errors reduced obviously after building patient safety culture （0 vs 1, 1 vs 4, 2 vs 10, respectively）, and active reports about nursing defects increased from 3 to 14. Conclusions Building a safety culture in EICU canenhance nurses＇ security awareness and their capabilities of identifying and preventing nursing risks, so as to improve nursing quality and assure patients safety.

关 键 词：重症监护室 急诊 护理管理研究 安全文化 

分 类 号：R47[医药卫生—护理学]