技术改良结合专科培训用于伤口护理中心的管理实践  

Management practice of improved techniques combined with specialty nursing training use to wound care center

作　　者：蒋琪霞[1] 王桂玲[2] 彭青[1] 黄秀玲[1] 李晓华[2] 

机构地区：[1]南京军区南京总医院门诊伤口护理中心,210002 [2]南京军区南京总医院门诊部,210002

出　　处：《中国护理管理》2016年第7期994-999,共6页Chinese Nursing Management

基　　金：南京军区创新课题(MS117)

摘　　要：目的：调查技术改良结合专科培训的管理方法在伤口护理中心专科管理中应用的效果。方法：从技术改良入手，2013-2014年改良和应用（改良应用阶段）5项伤口护理技术（包含30项技术流程及15项管理流程），2015年对其中16项技术流程和6项管理流程进行再改进和应用（优化应用阶段），并通过角色扮演、专科门诊跟训、疑难伤口个案护理报告、考核流程等方法培训护士为患者解决问题的能力。比较两阶段的实施效果。结果：改良应用和优化应用两阶段均无纠纷投诉，不良事件为Ⅲ级和Ⅳ级，发生率0.01%～0.02%。两阶段每月专科护理门诊量和治疗量有增加，以治疗量增加较明显（P〈0.05），其中清创、负压和红光治疗量优化应用阶段明显增加（P〈0.05）。伤口治愈率无统计学差异（P〉0.05）。优化应用阶段患者满意率提高（P〈0.05）。结论：技术改良结合专科培训有助于伤口护理中心的安全和质量管理，提高护理质量，降低伤口护理风险。Objective： To research the effects of wound care center management with the methods of improving technique procedures combined with specialty nursing training. Method： Starting from technical improvement, 5 wound care techniques contained 30 procedure processes and 15 management processes were improved and used from 2013 to 2014 （improved application stage）. Out of them, 16 procedure processes and 6 management processes were re-improved and used （optimum application stage） in 2015. Nurses were trained to use these processes by role playing, shadowing of certiifed wound nurse specialist, complex case report and evaluation processes in order to enhance clinician＆#39;s problem solving skills. Indicators： Quaterly case study and practical exams to nurses. The number of dispute and complain, incidence of adverse events and level, number of specialty nursing clinic and wound care, technique treatment, wound healing rate and satisfactory level of patients every month and comparison of the effects of between two steps. Results： No dispute and complain happened between two stages. The adverse events level were III and IV and incidence rate was 0.01%-0.02%. The number of specialty nursing clinic and wound care visits increased. The number of debridement, negative wound pressure therapy and red light therapy in optimum application stage was more than ones in improved application stage （P〈0.05） and patients satisfactory level enhanced in optimum application stage （P〈0.05） and healing rate between two stages was not signiifcant （P〉0.05）. Conclusion： Techniques improved combined with specialty nursing training methods were helpful to manage safety and quality for wound care center and beneifcial to improve nursing quality and reduce risk of wound care complications.

关 键 词：伤口护理 安全管理 护理管理 专科护理培训 

分 类 号：R47[医药卫生—护理学]