分级管理模式在急危重症患者CT检查护理质量改进中的实施与成效  

Implementation and effectiveness of graded management model in nursing quality improvement CT examination in critically ill patients

作　　者：刘俊伶 赵丽 蔡莉 兰芳 李雪 Liu Junling;Zhao Li;CaiLi;Lan Fang;Li Xue(Department of Radiology,Daping Hospital,Army Medical University,Chongqing,400042,China)

机构地区：[1]陆军军医大学大坪医院放射科,重庆400042

出　　处：《中国实用护理杂志》2020年第35期2741-2746,共6页Chinese Journal of Practical Nursing

基　　金：重庆市科卫联合医学科研项目(2019ZDXM049)。

摘　　要：目的探讨分级管理模式在急危重症患者CT检查护理质量改进中的应用效果,以保证患者检查的安全。方法建立急危重症CT检查分检评估方案,以患者病情的危险程度确定优先检查秩序,并针对性实施分级护理。同时使用绿色通道信息评估软件,增设导航护理岗位,为分级管理的实施提供保障。采取便利抽样法,将2017年4月至2018年4月检查的3 110例患者为实施前组,接受传统的管理模式;将2018年5月至2019年8月检查的3 189例患者为实施后组,采用分级管理模式。比较2组患者检查及时性,准备完好率,患者安全相关问题发生率,检查成功率,患者满意率,临床满意率等。结果分级管理模式提高了检查及时率(t值为15.240、9.473、22.003,P<0.01)、准备完好率(χ^(2)值为147.135,P<0.01)、患者满意率(χ^(2)值为26.662、45.214、18.683,P<0.01)、检查成功率(χ^(2)值为212.961,P<0.01),减少患者安全相关问题发生率(χ^(2)值为8.363,P<0.05)等。结论急危重症患者CT检查分级管理模式的实施降低了检查的风险,提升了影像检查护理服务内涵,保障了患者的安全。Objective To explore the application effect of graded management mode in nursing quality improvement CT examination of critically ill patients and make sure of the safety of patient examination.Methods Established an evaluation plan for hierarchical checking of CT examinations for critically ill patients,determined the priority order of examinations based on the degree of danger of the patient's condition,and implemented graded nursing in a targeted manner.At the same time,a multi disciplinary cooperation team was established,the green channel information evaluation software was userl and navigation nursing posts were added to ensure the implementation of grading management.Convenience sampling,from April 2017 to April 2018,3110 patients were examined as the pre implementation group,using traditional nursing methods.From May 2018 to August 2019.3189 patients were examined as the post implementation group.using hierarchical management mode.The timeliness ofexamination,the rate of readiness,the incidence of patient's safety related problems,the rate of successful examination,the rate of patients'satisfaction,and the rate of clinical satisfaction were compared between the two groups.ResultsThe grading management mode improved the rate of timely examination(P<0.01).the rate of readiness(P<0.01),the rate of patients’satisfaction(P<0.01),the rate of clinical satisfaction.the rate of sucessful examination(P<0.01),shortened the waiting time(P<0.01),and reduced the rate of patient's safety related problems(P<0.05).Conclusion The implementation of grading management mode of CT examination in critical patients reduces the risk of examination,improves the connotation of nursing services for imaging examination,and guarantees the safety of patients.

关 键 词：急危重症 X线计算机断层扫描 分检评估 分级护理 

分 类 号：R47[医药卫生—护理学]