择期手术患者非计划出院分析与对策  

Analysis and Countermeasures of Unplanned Discharge among Selective Surgery Patients

作　　者：吴虎兵[1] 赵莉丽[2] 陈剑铭[1] 夏志伟[3] 

机构地区：[1]北京大学第三医院,北京100191 [2]首都医科大学附属北京同仁医院,北京100730 [3]北京大学第三医院医务处,副处长主任医师北京100191

出　　处：《中国卫生质量管理》2015年第4期28-32,共5页Chinese Health Quality Management

摘　　要：目的明确择期手术患者非计划出院的禁忌症原因,探讨针对性改进对策。方法利用病案首页信息系统,按国际疾病分类标准检索出院诊断编码含有Z53.001的病例,分析禁忌症原因及患者性别、年龄、住院时间等对禁忌症的影响。结果非计划出院患者"因禁忌症未进行外科或其它操作"共1 533例,占同期手术/操作患者的2.85%。禁忌症原因主要有症状、体征和临床与实验室异常,循环系统疾病,呼吸系统疾病等;患者不同性别、年龄、住院时间的非计划出院禁忌症原因表现不同。结论降低择期手术患者因手术禁忌非计划出院发生率,需要医院、临床科室、医生、护士等共同参与,积极制定相应管理措施并严格执行。Objective To investigate the reasons of contraindications for unplanned discharge in surgery patients, and explore the countermeasures. Method By using medical record information system, patients＇ records were retrieved with discharge diagnosis code containing Z53. 001 according to the International Classification of Diseases. The reasons of contraindications and the effect of gender, age and length of stay on it were analyzed. Result There were 1533 unplanned discharge patients without surgical operations because of contraindications, accounting for 2.85% of surgery or operation cases during the same period. The main contraindications included abnormal symptoms, signs, clinical and laboratory test results, circulatory system diseases, and respiratory diseases. The reasons of contraindications in unplanned discharge patients differed according to gender, age group, and length of stay. Conclusion To reduce unplanned discharge caused by contraindication among selective surgery patients, it is essential for the cooperation of hospital, clinical departments, doctors and nurses to develop and implement corresponding man- agement measures.

关 键 词：择期手术 患者 非计划出院 禁忌症 ICD-10 

分 类 号：R473.6[医药卫生—护理学]