应用根本原因分析法解决护士延迟下班问题的成效  

Effect of Root Cause Analysis on Reducing Nurses' Extended Work Hour

作　　者：郝婧[1] 杨红梅[1] 王兴萍[1] 孙静[1] 陈曦[1] 蒋博[1] 郭俊艳[1] 

机构地区：[1]中国人民解放军总医院心血管内科,北京100853

出　　处：《护理学报》2014年第17期9-11,共3页Journal of Nursing（China）

摘　　要：目的探讨根本原因分析法在改善护士延迟下班问题的应用效果。方法引入根本原因分析法概念,通过成立根本原因分析法小组,设计延迟下班现况调查表,对延迟下班的原因进行解析,最终确立根本原因为:缺少规范化的交接班流程;接诊新入患者不规范;主治医师查房时间及医嘱下达时间过晚。针对根本原因,拟定实施对策:由临床护理专家、临床责任组长及医疗专家在总结临床经验的基础上共同制定护士交接班流程,并形成统一标准;通过现场查看50名护士接诊新入患者的情况,统计接诊缺陷条目,分析不规范的原因,建立新入患者接诊规范流程;护士长、主班护士与主管、主治医师进行沟通、协商,最终达成一致规范,尽早集中调整患者长期用药医嘱(上午10:30之前,最迟不超过11:00),并将这一规范作为新入科医师的培训内容之一。结果实施根本原因分析法后,护士延迟下班的平均时间及延迟下班率较之前明显下降。结论应用根本原因分析法改善了护士延迟下班的状况。Objective To explore the effect of Root Cause Analysis （RCA） on reducing nurses ’ extended work hour. Methods The concept of RCA was introduced and a RCA team was established to analyze the causes of nurses ’ extended work hour through a self-designed questionnaire. The causes of extended work hour included lack of standardized change of shift and reception process of new patients, late ward round and medical order. Then the improvement measures including formulation of new change of shift and reception process of new patients based on clinical experience of nursing experts and early medical order from doctors were implemented. Results After the implementation of new measures, there was a significant reduction in average extended work hour and the occurrence of extended work hour. Conclusion RCA is effective for reducing nurses’ extended work hour.

关 键 词：根本原因分析法 护士 延迟下班 护理管理 

分 类 号：R47[医药卫生—护理学] C931.3[医药卫生—临床医学]