闭环管理模式在呼吸监护人工气道患者风险管理中的应用价值研究  

Research on the application value of closed-loop management mode in the risk management of patients with artificial airway in respiratory monitoring

作　　者：邵丽丽[1] 张艳[2] 施金梅 朱敏[1] 丁嘉敏 SHAO Li-li;ZHANG Yan;SHI Jin-mei;ZHU Min;DING Jia-min(Ward of respiratory and critical care medicine,Affiliated Hospital of Nantong University,Jiangsu Province Nantong 226001,China;Ward 1 of respiratory and Critical Medicine Department of Affiliated Hospital of Nantong University,Jiangsu Province Nantong 226001,China)

机构地区：[1]南通大学附属医院呼吸与危重症医学科监护病区,江苏南通226001 [2]南通大学附属医院呼吸与危重症医学科一病区,江苏南通226001

出　　处：《中西医结合心血管病电子杂志》2020年第32期23-26,共4页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏现代医院管理研究中心医院管理研究课题,项目编号:jsy-3-2019-063;课题名称:闭环管理模式在人工气道患者风险管理中的应用研究。

摘　　要：目的探讨和评价闭环管理模式在呼吸监护人工气道患者风险管理中的应用研究价值。方法选取2018年01月~2020年06月我院呼吸与危重症医学科监护病区收治的建立人工气道患者84例,以2019年03月实施闭环管理模式时间作为分界线,将实施前的40例人工气道患者设为对照组,实施后的44例人工气道患者设为观察组。对照组接受常态化预见性人工气道风险管理模式,观察组接受全程监控与科学管理、同质化管理的闭环管理模式。对比分析两组患者人工气道护理质量敏感指标及相关并发症发生情况。结果观察组患者人工气道各项敏感指标中医院内获得性肺炎(HAP)、呼吸机相关性肺炎(VAP)发生率、气管插管、切管切开非计划性拔管的发生率等结果指标均明显低于对照组,观察组平均呼吸监护住院时间、费用和病死率也明显低于对照组,差异有统计学意义(P<0.05)。观察组人工气道各项敏感指标中急救物品药品完好率、人工气道管道固定规范率、导管滑脱风险评估率、预防导管滑脱护理措施落实率、监测气囊压落实率、气道湿化满意率和吸引操作规范率等过程指标达标率均明显高于对照组,观察组结果指标中出院患者满意率及护士工作满意度人工气道护理工作质量考核各项目及总分也明显高于对照组,差异有统计学意义(P<0.05)。结论闭环管理模式可显著提高呼吸监护人工气道患者风险管理护理工作质量,可减轻患者痛苦,降低护理不良事件的发生率,提升护理内涵建设,提高患者满意度。Objective Discuss and evaluate the application research value of closed-loop management mode in the risk management of artificial airway patients in respiratory monitoring.Methods We selected 84 patients with artificial airways admitted to the intensive care unit of the Department of Respiratory and Critical Care Medicine of our hospital from January 2018 to June 2020.The time of implementation of the closed-loop management model in March 2019 was used as the dividing line.Forty patients with artificial airway were set as the control group,and 44 patients with artificial airway after the implementation were set as the observation group.The control group accepted the normalized predictive artificial airway risk management model,and the observation group accepted the closed-loop management model of full-process monitoring,scientific management,and homogeneous management.Comparative analysis of the two groups of patients with artificial airway care quality sensitive indicators and related complications.Results Observation group's artificial airway sensitive indicators,the incidence of hospital-acquired pneumonia(HAP),ventilator-associated pneumonia(VAP),tracheal intubation,and tube incision unplanned extubation and other outcome indicators They were significantly lower than those of the control group,and the average length of hospitalization,expenses and mortality of respiratory monitoring in the observation group were also significantly lower than those of the control group(P<0.05).Among the various sensitive indicators of the artificial airway in the observation group,the medical integrity rate of first aid supplies,the standardized rate of artificial airway pipe fixation,the risk assessment rate of catheter slippage,the implementation rate of nursing measures to prevent catheter slippage,the implementation rate of monitoring balloon pressure,and the satisfaction rate of airway humidification The compliance rate of process indicators such as the rate of attracting and operating norms was significantly higher than

关 键 词：人工气道 气道湿化 闭环管理 敏感指标 护理质量 满意度 

分 类 号：R473[医药卫生—护理学]