预防成人经口气管插管非计划性拔管集束化护理策略应用效果的持续追踪与评价  

Continuous follow-up and effect evaluation on prevention of adult oral tracheal intubation unplanned extubation

作　　者：夏欣华[1] 王莹[2] 田丽[3] 张岚[4] 刘鸿梅[5] 马虹[6] 赵静 孙艳玲[1] 张紫君 XIA Xinhua;WANG Ying;TIAN Li;ZHANG Lan;LIU Hongmei;MA Hong;ZHAO Jing;SUN Yanling;ZHANG Zijun(Department of Nursing,Tianjin TEDA Hospital,Tianjin,300457,China)

机构地区：[1]天津市泰达医院护理部,天津市300457 [2]天津市第一中心医院护理部 [3]天津市第三中心医院护理部 [4]天津医科大学总医院护理部 [5]天津市第三中心医院重症医学科 [6]天津市人民医院护理部 [7]天津医科大学肿瘤医院重症医学科

出　　处：《中国护理管理》2023年第12期1780-1784,共5页Chinese Nursing Management

基　　金：天津市医院协会医院管理研究项目(2022zz14)。

摘　　要：目的:持续追踪2018版预防成人经口气管插管非计划性拔管集束化护理策略应用效果,为ICU护士临床护理决策提供参考。方法:2018年6月—12月遴选天津市11家医院试行策略有效后,进行全市推广,并连续4年进行追踪与效果评价。结果:项目推广后,2019年—2022年,气管插管非计划性拔管率中位数持续为0,策略执行合格率与各条目执行率存在波动,2020年、2021年各有1项条目执行率低于目标值,2022年有2项条目执行率低于目标值,其他条目执行率达到目标值。结论:2018版预防成人经口气管插管非计划性拔管集束化护理策略内容具有科学性、可行性和执行有效性,推广应用后可提高护理质量,降低气管插管非计划性拔管率,保障患者安全。Objective:To evaluate continuous effects of cluster nursing strategy for preventing tracheal intubation unplanned extubation in adults outlined in the 2018 edition provides reference for clinical nursing decision-making for ICU nurses.Methods:From June to December 2018,the strategy was implemented in 11 selected hospitals in Tianjin and proved to be effective.Following its success,the strategy was then widely promoted throughout the city.Continuous tracking and evaluation of its effects were conducted for four consecutive years.Results:After the implementation of the project,from 2019 to 2022,the median rate of unplanned extubation remained at 0.However,the compliance rate of overall strategy execution and individual item execution showed fluctuations.In 2020 and 2021,two items were below the target value,and in 2022,two items were also below the target value.Other items achieved the target value.Conclusion:The content of the 2018 edition of cluster nursing strategy for preventing tracheal intubation unplanned extubation in adults is scientific,feasible and effective,and its popularization and application can improve the quality of nursing care,reduce the rate of unplanned extubation of tracheal intubation,and ensure the safety of patients.

关 键 词：非计划性拔管 气管插管 评估 护理质量 患者安全 持续质量改进 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]