根本原因分析法在儿科门诊护患冲突中的应用效果分析及思考  

Application Effect Analysis of Root Cause Analysis in Nurse-patient Conflict in Pediatric Clinic and Reflection

作　　者：王荣花[1] 贺丽霞[1] 尹小妹[1] 陈宁[1] 王小琴 房夏玲[1] WANG Ronghua;HE Lixia;YIN Xiaomei;CHEN Ning;WANG Xiaoqin;FANG Xialing(Department of Pediatrics,the First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061,China;Department of Nursing,Xi＇an Jiaotong University HealthScienceCenter,Xi＇an 710061,China)

机构地区：[1]西安交通大学第一附属医院儿科,陕西西安710061 [2]西安交通大学医学部护理系,陕西西安710061

出　　处：《中国医学伦理学》2018年第9期1152-1156,共5页Chinese Medical Ethics

摘　　要：目的探讨根本原因分析法(RCA)在改善儿科门诊护患关系及陪护家属满意度方面的应用效果。方法选取2016年1月1日-12月31日在儿科门诊就诊及输液的患儿陪护家属3265例作为对照组;选取2017年1月1日-12月31日就诊及输液的患儿陪护家属3268例作为实验组,实验组是在对照组年度发生较多门诊护患冲突后,采用RCA确定引发护患冲突的根本原因,进行分析,对门诊护理工作进行调整,制定出切实可行的护理方法。记录两组护患冲突发生率、发生原因及次数情况;对比两组陪护家属对护理工作的满意度。结果实验组护患冲突发生率仅为1.01%,明显低于对照组(3.71%),两组对比差异具有显著意义(P<0.01)。实验组陪护家属在候诊、健康知识宣教、操作规范及医疗环境4个维度的服务满意度分别为94.80%、95.44%、95.26%、97.86%,均明显高于对照组90.26%、90.57%、89.98%、89.46%(P<0.01)。结论运用RCA制定并实施相应护理方案,可有效提高陪护家属对护理工作的满意度,改善护患关系,降低护患冲突发生率。Objective： To explore the application effect of root cause analysis（RCA） in improving pediatric nurse-patient relationship and accompanying family members＇ satisfaction. Methods： 3265 children＇s accompanying family members were selected as the control group from January 1 to December 31,2016 in pediatric clinic;3268 children＇s accompanying family members were selected as the experimental group from January 1 to December31,2017 in pediatric clinic. The experimental group used RCA to determine the root causes of nurse-patient conflicts after more outpatient nurse-patient conflicts occurred in the control group in the year. The analysis was conducted to adjust the outpatient nursing work and formulate a practical nursing method. The incidences,causes and times of the nurse-patient conflict in two groups were recorded; accompanying family members＇ satisfaction to nursing service was compared between the two groups. Results： The incidence of conflict was only 1. 01% in the experimental group,significantly lower than that in the control group（3. 71%）（P〈0. 01）. The accompanying family members＇ service satisfaction in the four dimensions of waiting-list,health knowledge education,practice and medical environment in the experimental group were 94. 80%,95. 44%,95. 26% and 97. 86%,respectively,significantly higher than those in the control group（90. 26%,90. 57%,89. 98% and 89. 46%）（P〈 0. 01）.Conclusion： The use of RCA and developing and implementing the corresponding nursing programs can effectively improve accompanying family members＇ satisfaction to nursing work,improve nurse-patient relationship and reduce the incidence of nurse-patient conflicts.

关 键 词：儿科护理 根本原因分析法 护患冲突 护理伦理 

分 类 号：R-052[医药卫生]