临床基本护理技术风险-频次图的设计及应用  

Design and Application of the Risks and Frequency Gram of Basic Clinical Nursing Techniques

作　　者：毕娜[1,2] 郭尉 王建荣[1] 

机构地区：[1]解放军总医院护理部,北京100853 [2]解放军第309医院骨科中心,北京100091 [3]解放军陆军船艇学院门诊部,江苏镇江212003

出　　处：《解放军护理杂志》2014年第5期25-27,55,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：军队"十一五"面上课题(06MA051)

摘　　要：目的评价临床常用基本护理技术风险等级,绘制临床基本护理技术风险-频次图,为护士分层管理和护理技术授权提供借鉴。方法采用自行设计的《20项临床常用基本护理技术风险半定量评价表》,对2012年10月北京市3所三级甲等医院临床常用20项基本护理技术风险发生可能性、风险威胁性和护理纠纷可能性进行评价,同期统计3所医院上述20项基本护理技术的操作次数,应用CHISS 2011统计软件建立数据库并进行统计分析。结果 20项临床常用的基本护理技术风险值和操作频次构成比的散点图显示:风险值R≥6为高风险操作,6>R≥3为中风险操作,R<3为低风险操作;操作频次的构成比≥10%为高频次操作。高风险高频次操作项目共计0项;高风险低频次操作项目共计3项,分别为PICC穿刺、PICC维护和动脉采血;中风险低频次操作项目共计11项,分别为留置导尿、吸痰、鼻饲、灌肠、卧位护理、静脉输液、静脉采血、特殊口腔护理、膀胱冲洗、静脉注射和吸氧;中风险高频次操作项目共计1项,为静脉续滴;低风险低频次操作项目共计3项,分别为肌内及皮下注射、雾化吸入和会阴护理;低风险高频次操作项目共计2项,分别为生命体征及出入量观察记录和床单元整理。结论基本护理技术风险-频次图可指导护士分层管理和分级培训,提高护理风险管理的预见性和满意度。Objective To evaluate the risks of clinical basic nursing techniques,drawing a scatter gram of the risks and frequency of the techniques,offering references for hierarchical management and technology licensing of nursing.Methods 20 kinds of basic nursing techniques being used in 3 hospitals in Beijing were evaluated by self-designed LEC rating scales in Oct.2012,including the probability,severity and probability of nursing tangle.The frequency of each nursing techniques were counted concurrently.All the data were analyzed with the CHISS 2011 software.Results The scatter diagram shows that the 20 techniques were divided into 4 kinds according to the risks scales and frequency.Among them,there were 3 high risks low frequency techniques,which included PICC puncture,PICC management and arteriopuncture;11 mild risks low frequency techniques,including indwelling catheterization,sputum suction,tube feeding,enemata,lying position,intravenous infusion,venous blood collection,special oral care,bladder irrigation,intravenous injection and oxygen inhalation;1 mild risks high frequency technique,which was continued intravenous infusion;3 low risks low frequency techniques,which were intramuscular and subcutaneous injection,aerosol inhalation and diaper care;2 low risks high frequency techniques,which were measurement of the vital signs and bed making.Conclusion Risks and frequency gram of basic nursing techniques can direct the training and management of nursing resources hierarchically,and improve the foreseeability and satisfaction of nursing risk management and pertinence to improve the satisfaction level.

关 键 词：基本护理技术 风险评价 护士分层管理 护理满意度 护理管理 

分 类 号：R197.323[医药卫生—卫生事业管理]