基于患者360视图的护理不良事件管理系统构建与应用  

Construction and Application of Nursing Adverse Events Management System Based on 360-Degree View

作　　者：孙萌[1] 骆金铠[1] 王露露 李宏洁 毛文平 SUN Meng;LUO Jinkai;WANG Lulu(Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China;不详)

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国卫生质量管理》2024年第4期54-58,共5页Chinese Health Quality Management

基　　金：2021年首都医科大学附属北京友谊医院“扬帆”计划(编号:ZYLX202102)。

摘　　要：目的构建基于患者360视图的护理不良事件管理系统,优化护理不良事件管理流程。方法护理不良事件管理系统包含可视化安全预警、向导式上报及反馈追踪、分层系统培训3个功能模块,于2021年1月正式应用。结果系统应用后,压力性损伤、给药错误以及不良事件整体发生率均较应用前下降,其中给药错误发生率差异具有统计学意义(P<0.05),而管路滑脱、跌倒/坠床的发生率较应用前略有增加;护理不良事件整改达标率由92.8%提高至95.7%(P<0.05);组织科护士长培训12次,组织全院护士长专项培训20余次,开展护理质量安全管理标准化操作规程工作坊12场次。结论基于患者360视图的护理不良事件管理系统可以提高护理风险识别率,降低护理不良事件发生率。下一步需在充分考虑患者特点与需求的基础上进一步优化系统功能。Objective To construct a management system for nursing adverse events based on 360-degree view,optimize the management process of nursing adverse events.Methods The nursing adverse event management platform included three modules:visual safety warning,guided reporting and feedback tracking,and hierarchical system training,and was officially applied in 2021.Results After the application of the system,the incidence of pressure injuries,medication errors,and overall adverse events decreased compared with those before the application,and the incidence of medication errors decreased more significantly(P<0.05).The incidence of pipeline slippage and falls/falling out of bed increased slightly compared with before application.The compliance rate of corrective measures for nursing adverse events increased from 92.8%to 95.7%(P<0.05).12 training sessions were organized for head nurses,more than 20 special training sessions were organized for head nurses in the whole hospital,and 12 SOP workshops on nursing safety and quality management were organized.Conclusion The management system of nursing adverse events based on 360-degree view can improve the identification rate of nursing risks,reduce the incidence of nursing adverse events.The next step is to further optimize the system function on the basis of fully considering the characteristics and needs of patients.

关 键 词：360视图 护理不良事件 患者安全 质量与信息化 

分 类 号：R47[医药卫生—护理学]