医护患一体化管理模式在神经重症监护病房躁动患者医用管道安全管理中的应用  

Application of the management mode participated by doctors, nurses and patients in the safety management of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit

作　　者：刘岩[1] 吴孟航[1] 刘帆[1] 

机构地区：[1]四川大学华西医院重症医学科,成都610041

出　　处：《华西医学》2017年第2期242-245,共4页West China Medical Journal

摘　　要：目的探讨医护患一体化管理模式在神经重症监护病房(Neurosurgery Intensive Care Unit,NICU)躁动患者医用管道安全管理中的效果。方法选择施行医护患一体化管理模式前(2013年5月17日—11月22日)入住NICU的133例躁动患者(对照组)与施行医护患一体化管理模式后(2014年5月17日—11月22日)入住NICU的119例躁动患者(研究组),比较其医用管道意外拔管情况。结果研究组各种医用管道的意外拔管率均低于对照组,其中研究组与对照组患者的尿管意外拔管率(0.67%、4.32%)、胃管意外拔管(2.26%、10.14%)、气管插管意外拔管(1.08%、7.84%)和动脉置管意外拔管率(1.12%、6.93%)比较差异有统计学意义(P<0.05)。结论医护患一体化管理模式能有效地降低神经重症伴躁动患者的意外拔管发生率,减少护理差错及医患/护患纠纷的发生,确保躁动患者在NICU住院期间治疗和护理的安全进行。Objective To determine the effects of the management mode participated by doctors, nurses and patients on the safety of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit（NICU）.Methods A total of 133 restlessness patients treated between May 17 and November 22, 2013 were included in the study as control group, who were admitted to the NICU before application of the management mode participated by doctors,nurses and patients; another 119 restlessness patients treated between May 17 and November 22, 2014 were included in the study as research group, who were admitted to the NICU after application of the management mode participated by doctors, nurses and patients. Then we compared the accidental extubation situation between the two groups.Results The accidental extubation rate of all kinds of medical tubes in the research group was lower than that in the control group, among which the extubation rate of urethral catheter（0.67% vs. 4.32%）, gastric tube（2.26% vs. 10.14%）,trachea cannula（1.08% vs. 7.84%）, and arterial cannulation pipeline（1.12% vs. 6.93%） was significantly different between the two groups（P〈0.05）. Conclusion The management mode participated by doctors, nurses and patients can effectively reduce the accidental extubation rate of medical tubes for restlessness patients, prevent the occurrence of adverse events and ensure the treatment and nursing safety in the NICU.

关 键 词：医护患一体化 神经重症监护病房 躁动患者 医用管道安全管理 

分 类 号：R473.74[医药卫生—护理学]