护理中断事件管理的实践与成效  

Practice and effectiveness of management in nursing interruptions

作　　者：谢建飞[1] 刘佳[1] 刘立芳[1] 王琰[1] 戴丽红[1] 吴小霞[2] 丁四清[2] 曾赛男[3] 周建大[4] 

机构地区：[1]中南大学湘雅三医院移植中心,长沙市410013 [2]中南大学湘雅三医院护理部,长沙市410013 [3]中南大学湘雅三医院院感科,长沙市410013 [4]中南大学湘雅三医院科研科,长沙市410013

出　　处：《中华护理杂志》2016年第8期951-955,共5页Chinese Journal of Nursing

基　　金：国家临床重点专科建设项目(国卫办医函[2013]544号);湖南省自然科学基金项目(13JJ5015)

摘　　要：目的有效开展护理中断事件管理的改进实践，评价其应用成效。方法通过团队的组建、前期调查分析、护理中断事件干预方案的制订和实施、有效质量控制等措施，在2个移植外科病房开展护理中断事件管理的改进实践。结果干预后2个月护理中断事件发生频次较干预前减少；干预后消极型结局护理中断事件发生率较干预前显著下降（x2=38．536，P〈0．001）。干预后科室护理质量和患者满意度均在全院护理单元中排名第一。干预后护士“交班类”和“交流类”工作的时间均明显缩短；干预后护士一般自我效能感得分（3．03±0．39）与干预前（2．67±0．52）比较，差异具有统计学意义（t=6．210，P〈0．001）。结论通过组建课题团队、结合前期数据设置干预项目、以“知-信-行”模式和PDCA循环等落实质量控制，创新并实践护理中断事件干预方案，可有效改善护理工作质量与结局，有利于提高护士工作效率与自我效能感。基于护理中断事件管理改进的实践是护理质量持续发展的有力保障．具有重要的临床管理价值。Objective To effectively implement the management improvement measures in nursing interruptions （Nl）,and evaluate the application results. Methods The management improvement in NI was carried out through team building,baseline assessment and analysis,formulation and implementation of improvement measures and quality control,which was implemented in two transplant surgery wards. Results The frequency of NI was reduced after intervention. The rate of Negative NI decreased significantly（x2=38.536,P〈0.001）. The scores of nursing quality and patient satisfaction were ranked first in 40 nursing units after intervention. The working time of ＂Shift＂ and ＂Communication＂ were shortened significantly. The GSES score in nurses was improved from 2.67±0.52 to 3.03±0.39 （t =-6.210,P〈0.001）. Conclusion The organization of the project team,setting the activity project based on the preliminary data ,the use of KABP mode combined with PDCA cycle,the innovation and practice management improvement measures in NI,can effectively promote nursing quality and outcome,which is beneficial to improving working efficiency and self-efficacy in nurses. The implementation of management improvement in NI can guarantee sustainable development of nursing quality,and has important value for clinical management.

关 键 词：护理管理研究 中断 质量改进 

分 类 号：R47[医药卫生—护理学]