风险管理联合精准护理在老年慢性疾病患者躯体功能维护及安全管理中的应用研究  

Application of Risk Management Combined With Precision Nursing in Physical Function Maintenance and Safety Management of Older Patients With Chronic Diseases

作　　者：张琪 魏丹 高玥珊 蒋婷婷 陈茜 ZHANG Qi;WEI Dan;GAO Yueshan;JIANG Tingting;CHEN Qian(Geriatrics Center,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,China;Clinical Research Center for Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,China;Sichuan Key Laboratory of Nursing,Chengdu 610041,China)

机构地区：[1]四川大学华西医院老年医学中心/四川大学华西护理学院,成都610041 [2]四川大学华西国家老年疾病临床研究中心,成都610041 [3]护理学四川省重点实验室,成都610041

出　　处：《四川大学学报（医学版）》2023年第4期804-810,共7页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.72271172);四川省科技计划项目(No.2021YFS0154)资助。

摘　　要：目的探讨风险管理联合精准护理在老年慢性疾病(简称老年慢病)患者躯体功能维护及安全管理中的应用效果,为住院老年慢病患者躯体功能维护和预防跌倒方案的制定提供依据。方法从四川大学华西医院条件接近的老年病房中整群抽样,随机选择对照组和观察组。对照组采用常规护理,观察组在此基础上采用风险管理联合精准护理。主要观察指标为日常生活自理能力,次要观察指标为全天离床活动时间及输液时间、病房患者跌倒发生情况和住院天数。结果对照组109例和观察组110例患者完成研究。入院时,两组患者日常生活自理能力得分差异无统计学意义(P>0.05)。干预后,观察组患者日常生活自理能力得分(75.74±22.71)高于干预前(68.74±17.32),差异有统计学意义(t=2.435,P<0.05);对照组患者日常生活自理能力得分(70.36±21.90)高于干预前(69.14±18.29),但差异无统计学意义(t=0.549,P>0.05);且干预后观察组患者日常生活自理能力得分高于对照组,差异有统计学意义(t=2.973,P<0.05)。干预后,观察组患者住院期间全天离床活动时间(7.35±2.07)h高于对照组患者(4.11±2.62)h,差异有统计学意义(t=1.508,P<0.05)。观察组患者住院期间全天输液时间(1.68±0.19)h低于对照组患者(2.39±0.31)h,差异有统计学意义(t=-2.339,P<0.05)。两组患者跌倒发生情况和住院天数差异无统计学意义(P>0.05)。结论风险管理联合精准护理能够提高老年慢病患者的自理能力,增加其全天离床活动时间,减少其全天输液时间,不增加跌倒发生率,对医院安全管理中老年慢病患者躯体功能维护和预防跌倒有积极作用。Objective To examine the application effect of risk management combined with precision nursing in the maintenance of physical functions and the safety management of older patients with chronic diseases and to provide the basis for the formulation of physical function maintenance and fall prevention programs for older inpatients with chronic diseases.Methods The control group and the observation group were randomly selected by cluster sampling from geriatric wards of similar conditions in West China University,Sichuan University.The control group received conventional nursing care and the observation group had risk management combined with precision nursing on top of the conventional nursing care.The primary outcome indicator was activities of daily living(ADL).The secondary outcome indicators were the whole-day ambulation time and infusion time,the incidence of falls,and length-of-stay among patients.Results A total of 109 patients in the control group and 110 patients in the observation group completed the study.At the time of admission,there was no statistically significant difference between the ADL scores of the two groups(P>0.05).Among the patients in the intervention group,the post-intervention ADL scores of the observation group(75.74±22.71)were higher than the pre-intervention ADL scores(68.74±17.32)and the difference was statistically significant(t=2.435,P<0.05).Among the patients in the control group,the post-intervention ADL scores of the control group(70.36±21.90)were higher than the pre-intervention ADL scores(69.14±18.29)and the difference was not statistically significant(t=0.549,P>0.05).In addition,the post-intervention ADL score of the observation group was higher than that of the control group,and the difference was statistically significant(t=2.973,P<0.05).After intervention,patients in the observation group had higher whole-day ambulation time during hospitalization(7.35±2.07)than those in the control group did(4.11±2.62),showing significant difference(t=1.508,P<0.05).The whole-day infus

关 键 词：老年人 住院 风险管理联合精准护理 躯体功能 安全管理 整群抽样 临床对照研究 

分 类 号：R473[医药卫生—护理学]