基于DEMATEL的非计划性拔管风险因素分析  

Risk factors of unplanned extubation based on the decision making trail and evaluation laboratory method

作　　者：金环[1] 喻姣花[1] 王玉梅[2] 张学辉[3] 李瑶[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院护理部,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院综合科,湖北武汉430022 [3]华中科技大学同济医学院附属协和医院小儿外科,湖北武汉430022

出　　处：《护理学杂志》2016年第9期52-54,共3页Journal of Nursing Science

摘　　要：目的应用决策试验与评价实验室方法（DEMATEL）确定非计划性拔管的关键风险因素，为临床管道管理提供决策依据。方法对49例非计划性拔管不良事件，由管道护理小组现场认证确定19项风险因素；选取35名专家进行2轮函询，以函询结果构建风险因素的直接影响矩阵，运用DEMATEL软件计算综合影响度（Tr）、被影响度（Tc）、中心度（Mi）和原因度（Ri）。结果专家积极性为10。％，权威程度0．857，协调系数0．297（P〈0．05）；19项风险因素的Tr为0～2．535，Tc为0～2．321，Mi为0．653～3．891，Ri〉0的风险因素有10个，Ri〈0的风险因素有9个。结论基于DEMATEL分析影响非计划性拔管的风险因素，其主要风险因素有操作方法、固定方法、肢体约束、健康教育及高危人群评估，其中操作方法为最关键因素。Objective To determine the risk factors of unplanned extubation using the decision making trail and evaluation laboratory （DEMATEL） method, and to provide reference for catheter management. Methods Nineteen risk factors of unplanned extubation were confirmed through 49 cases of unplanned extubation, then a two-round Delphi survey was conducted on 35 experts to collect their views on relevance of these risk factors. Direct relation matrix was generated to determine the ＂influenced-influencing factors＂, and ＂cause and effect diagram＂ （Tr, Tc, Mi and Ri） using DEMATEL software. Results The response rate of questionnaire was 100%; the coefficient of expert authority was 0. 857; and the coordination coefficient was 0. 297 （P〈0.05）. The Tr of 19 risk factors ranged from 0 to 2. 535, Tc was between 0 and 2. 321, and Mi was 0. 653--3. 891. Ten risk factors had Ri greater than 0, whereas the rest 9 factors showed Ri less than 0. Conclusion The risk factors of unplanned extubation were operating methods, securing styles, physical restriction, health education, and assessment of high risk patients. The key important factor was operating methods.

关 键 词：留置管道 非计划性拔管 决策试验与评价实验室方法 风险因素 

分 类 号：R472[医药卫生—护理学]