基于单元的综合安全项目在外科患者导管安全管理中的应用  

Application of comprehensive unit-based safety program in catheter safety management for surgical patients

作　　者：郑蕾[1] 徐颖[2] 匡洁[1] 严佶祺[1] 王芳[1] 张世瑜[3] 金艳[4] 王丽君 Zheng Lei;Xu Ying;Kuang Jie;Yan Jiqi;Wang Fang;Zhang Shiyu;Jin Yan;Wang Lijun(Department of Thyroid Vascular Surgery,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院甲状腺血管外科,上海200025 [2]上海交通大学医学院附属瑞金医院泌尿外科,上海200025 [3]上海交通大学医学院附属瑞金医院护理部,上海200025 [4]上海交通大学医学院附属瑞金医院肝胆外科,上海200025 [5]上海交通大学医学院附属同仁医院

出　　处：《护理学杂志》2023年第7期50-53,共4页Journal of Nursing Science

基　　金：上海交通大学医学院护理学科建设项目(护理学科青年人才项目);上海交通大学医学院附属瑞金医院课题(RJHK-2020-6)。

摘　　要：目的探讨基于单元的综合安全项目在外科患者导管安全管理中的应用效果。方法将外科术后置管患者3825例按时间顺序分为对照组(1861例)和干预组(1964例),分别实施导管常规管理和基于单元的综合安全项目管理。干预组通过组织安全科学培训、组建团队、通过意义建构识别缺陷及实施团队合作和沟通等方法,分析病区存在的导管安全问题,制订并实施相应导管安全干预措施。结果管理后干预组非计划拔管率显著低于对照组,病区导管质控中导管评估得分显著高于对照组(均P<0.05);护理人员安全文化水平得分较实施前有所提升。结论基于单元的综合安全项目管理,可有效降低非计划拔管率,提升护理人员导管评估意识和导管护理质量。Objective To explore the effect of applying comprehensive unit-based safety program(CUSP)in catheter safety management for surgical patients.Methods A total of 3825 patients keeping at least one catheter/tube in place after surgery were divided by chronological order into a control group(n=1861)which was subjected to routine catheter/tube management,and an intervention group(n=1964),who was managed with CUSP,in which,researchers made the following moves of organizing trainings,assembling the team,identifying defects through meaning construction,and implementing teamwork and communication,before analyzing problems lying in catheter/tube safety in the ward,and formulating and implementing catheter/tube safety intervention measures.Results The incidence rate of unplanned extubation in the intervention group was significantly lower than in the control group;result of catheter/tube assessment score in quality control inspection in the former group was significantly higher than in the latter group(P<0.05 for both).Nurses′safety culture scores after rollout of the program were higher than before.Conclusion CUSP management mode could reduce the incidence rate of unplanned extubation,improve nurses′awareness of catheter assessment and quality of catheter care.

关 键 词：手术患者 综合安全项目 导管 非计划拔管 导管护理 患者安全 

分 类 号：R472.9[医药卫生—护理学]