基于风险预警系统理论的护理风险层级管理体系构建及应用  

Establishment and application of a nursing risk hierarchical management system based on the risk early warning system

作　　者：陈云 江雅[1] 陈妙霞[1] 银琳[2] 蔡蕾[1] 方蘅英[1] Chen Yun;Jiang Ya;Chen Miaoxia;Yin Lin;Cai Lei;Fang Hengying(The Third Affiliated Hospital of Sun Yat-sen University,Department of Nursing,Guangzhou,510000,China;The Third Affiliated Hospital of Sun Yat-sen University,Department of Information Science,Guangzhou,510000,China)

机构地区：[1]中山大学附属第三医院护理部,广东广州510000 [2]中山大学附属第三医院信息科,广东广州510000

出　　处：《现代临床护理》2022年第4期60-65,共6页Modern Clinical Nursing

摘　　要：目的构建基于风险预警系统理论的护理风险层级管理体系,并验证其应用效果。方法基于风险预警系统理论,构建包含预警咨询系统、预警决策系统、预警执行系统和预警监督系统等层级预警系统,确定哨点预警指标,结合护士层级管理,形成护理风险层级管理体系。通过系统自动化评估、形成数字化护理决策、落实防范措施、建立层级反馈监督机制等步骤对住院患者的护理风险进行管理。比较实施前后全院护理不良事件发生率的差异。结果应用信息化层级护理风险管理体系后,全院跌倒、压疮、中心静脉导管(central venous catheter,CVC)非计划拔管、胃管非计划拔管不良事件发生率较实施前降低,实施前后比较,差异有统计学意义(P<0.001)。结论信息化层级护理风险预警体系的应用,实现了护理风险预警环节网络管理,可以有效地降低不良事件的发生,提高护理风险服务质量,保障患者的安全,是一种可靠、可控、高效、安全的护理风险管理模式。Objective To construct a hierarchical management mode for a low-level nursing risk pre-warning system in order to reduce the occurrence of adverse event and ensure the safety of patients.Methods Based on a risk early warning system,the hierarchical early warning system was constructed to determine the sentinel early warning parameters,and the refore to establish a nursing risk hierarchical management system with the combination of the hierarchical management of nurses.Such a hierarchical early warning system included a warning consulting system,a warning decision-making system,a warning executive system and a warning supervision system.The nursing risks of in patients were managed through the steps of system automatic evaluation,digital nursing decision making,implementation of preventive measures,and the establishment of hierarchical feedback and supervision mechanism.The incidences of adverse event in hospital were compared between pre-and post-implementation of the system.Results After the application of the informatisation hierarchical nursing risk management system,the incidences of adverse event in the hospital such as falls,pressure sores,unscheduled extubation of central venous catheter(CVC),unscheduled extubation of gastric tube,etc.were all significantly lowered(<0.01).Conclusions The informatisation hierarchical nursing risk early warning system realises the network-basedearly warning links in managing the nursing risks.It can effectively reduce the occurrence of adverse events,improve the quality of services in nursing risk management,and ensure the safety of patients.It is reliable,controllable,efficient and safe for nursing risk management.

关 键 词：风险预警系统 护理风险 层级管理 信息化管理 

分 类 号：R47[医药卫生—护理学]