风险管理策略在鼻胃管喂养护理中的应用  

Application of risk management in nursing care of nasogastric tube feeding patients

作　　者：王颖[1] 杨雪柯 尹世玉 黄丽红 汪晖 Wang Ying;Yang Xueke;Yin Shiyu;Huang Lihong;Wang Hui(Department of Nursing,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,湖北武汉430030

出　　处：《护理学杂志》2018年第18期1-4,共4页Journal of Nursing Science

基　　金：中华护理学会2016~2017年度科研课题立项项目(ZHKY201604);华中科技大学自主创新研究基金资助项目(2015TS084)

摘　　要：目的探讨对鼻胃管喂养患者实施护理风险管理的效果。方法对鼻胃管喂养患者实施鼻胃管喂养风险管理策略,即建立鼻胃管置管风险评估单,完善置管前评估;实施项目管理,制定鼻胃管喂养规范化指引;建立肠内营养视觉识别系统,降低给药错误风险;制订鼻胃管喂养集束化管理策略,实施全过程质量追踪;开展全员参与型规范化培训。在全院106个护理病区实施,比较实施风险管理策略前后的效果。结果实施后,置管高风险评估上报率、一次置管成功率、鼻胃管喂养关键监测指标落实率显著高于实施前(P<0.05,P<0.01),无鼻胃管置管错位事件发生。结论对鼻胃管喂养患者实施风险管理策略,有利于控制置管前高风险因素,提高一次鼻胃管置管成功率,减少鼻饲并发症,提高肠内营养输注安全性,保障患者安全。Objective To explore the effects of risk management in nursing care of nasogastric tube feeding patients.Methods Risk management of nasogastric tube feeding was applied in 106 nursing wards：researchers established a risk assessment sheet for nasogastric tube placement to optimize pre-placement assessment;they employed project management to formulate a standardized protocol for nasogastric tube feeding;they established a visual identification system for enteral nutrition therapy to reduce the risk of medication errors,and formulated a cluster of nasogastric tube feeding management bundles to enable total processing quality control;they carried out standardized training for all the nurses.The effects before and after the implementation of risk management strategies were compared.Results After implementation of risk management strategies,the reporting rate of high risk placement,the success rate of placement at the first attempt,and the implementation rate of key monitoring indicators were significantly improved（P〈0.05,P〈0.01）.No nasogastric tube dislocation occurred.Conclusion Risk management strategies of nasogastric tube feeding enable high risk factors control before placement,improve success rate of placement at the first attempt,reduce nasogastric complications,and enhance the safety of enteral nutrition infusion,which as a whole ensures patient safety.

关 键 词：鼻胃管喂养 肠内营养 风险管理 喂养护理 护理管理 

分 类 号：R47[医药卫生—护理学] C931.2[医药卫生—临床医学]