住院老年痴呆患者护理不良事件现况及影响因素分析  

An analysis on the nursing adverse events and its influencing factors in senile dementia inpatients

作　　者：李华[1] 慕琍萍 常亭玲 孙谷珍 倪芸[1] 邓丽丽[1] 耿丽[1] 吴冰[2] 陈若虹 

机构地区：[1]上海市长宁区精神卫生中心,200042 [2]上海市长宁区程家桥社区卫生服务中心 [3]四川省都江堰市精神卫生中心

出　　处：《中国实用护理杂志》2013年第23期28-31,共4页Chinese Journal of Practical Nursing

基　　金：上海市长宁区卫生局基金项目（20104Y06002）

摘　　要：目的调查住院老年痴呆患者护理不良事件发生率，并探讨护理不良事件发生的原因与影响因素。方法采用非惩罚性登记报告方法，登记调查2家医疗机构252例老年痴呆住院患者1年时间内的护理不良事件、原因以及对患者的健康影响。同时收集患者一般情况、住院时间、健康状况，并对其生活自理能力、总体衰退状况进行评估。结果252例住院老年痴呆患者1年共发生护理不良事件191起，平均每例患者发生护理不良事件0．8次，并造成7例患者死亡。护理不良事件以院内感染、伤害、导管护理、用药护理、约束带使用和皮肤护理事件为主，分别占护理不良事件总数的28．6％、15．5％、5．6％、5．2％、4．4％、4．0％。护理不良事件的主要原因有评估不到位、沟通不良、护理措施不当、护理不到位、培训不到位。此外，患者自身的健康状况与生活自理能力对护理不良事件的发生有较明显的影响。结论老年痴呆患者护理不良事件发生率较高，其原因除护理人员因素外，还与自身的健康状况与疾病特征有关。Objective To investigate incidence of nursing adverse events in senile dementia inpa- tients and to explore the causes and influencing factors. Methods Using a non-punitive reporting methods, we recorded nursing adverse events among 252 senile dementia within one year in 2 medical institutions, the categorization, causes and health effect were collected. At the same time, sociodemographic data, hospital stay, health status and Activity of Daily Living Scale, Global Deterioration Scale were investigated and assessed. Results Nursing adverse events happened in a total of 191 cases and caused seven death among 252 senile dementia inpatients in one years, there was 0.8 nursing adverse events occurred per year per patient. The top five kinds of nursing adverse events were nosocomial infection（28.6%）, injury（15.5%）, tube events（5.6% ）, medication（5.2% ）, restraint strap events（4.4% ）, skin nursing（4.0）. The main causes were inadequate assessment,ineffective communication,and insufficient training. In addition, the patients＇ health status, daily living and care had some certain impact on the nursing adverse events. Conclusions The results indicated that a higher incidence of nursing adverse events occurs in senile dementia, beside the nursing factors, related factors were characteristic symptoms and health status.

关 键 词：护理不良事件 住院老年痴呆患者 影响因素 

分 类 号：R473.74[医药卫生—护理学]