广西某市级综合三级甲等医院护理不良事件管理  

Management of nursing adverse events in a municipal tertiary hospital in Guangxi Zhuang autonomous region

作　　者：刘晓露[1] 罗远玲[1] 林利萍[1] 张梅[1] 宁成诚[1] LIU Xiaolu;LUO Yuanling;LIN Liping;ZHANG Mei;NING Chengcheng(Qinzhou Second People's Hospital,Qinzhou 535000,China)

机构地区：[1]钦州市第二人民医院,广西钦州535000

出　　处：《现代医院》2024年第8期1228-1230,1234,共4页Modern Hospitals

摘　　要：目的分析广西某市级综合三级甲等医院护理不良事件管理情况及对策。方法回顾性分析并总结广西某市级综合三级甲等医院2023年护理不良事件,以Logistic回归分析模型分析引起护理不良事件的原因并提出相应对策。结果2023年度合计发生121例护理不良事件,以跌倒事件最为突出,合计42例,占比34.71%,其次为药物外渗、药物安全事件、非计划性拔管事件,分别占比13.22%、9.92%及7.44%。Logistic回归分析模型得出,年龄≥70岁,合并其他疾病,巴塞尔指数评分≤40分、疼痛评分≥4分、管道滑脱风险评估≥10分、RASS镇静得分≥3分、NGASR评分≥9分、走失风险评估得分≥7分、GCS昏迷量表得分≤8分、压力性损伤评估量表≤10分和Morse评分≥45分为影响患者护理不良事件的危险因素。此外,护理人员护理风险意识淡薄,对患者健康宣教方法欠佳,未按制度落实护理操作等是导致护理不良事件发生的主要原因。结论高龄、合并其他疾病和住院量表评估结果较为危急,护理人员的护理职责和风险意识、制度落实不到位、操作不规范等,可增加护理不良事件发生风险。医院应通过优化管理制度和工作流程,加强护理人员培训,并针对护理不良事件拟定针对性的预防措施等,来提高护理管理质量,降低护理不良事件发生风险。Objective To analyze the management and countermeasures of adverse nursing events in a municipal tertiary hospital in Guangxi Zhuang Autonomous Region.Methods The adverse nursing events in 2023 in a municipal tertiary hospital in Guangxi were retrospectively analyzed.Logistic regression analysis was utilized to identify the causes of these adverse events and propose suitable countermeasures.Results In 2023,a total of 121 adverse nursing events were recorded,with falls being the most prominent(42 cases,accounting for 34.71%),followed by drug extravasation,drug safety incidents and unplanned extubation,accounting for 13.22%,9.92%,and 7.44%respectively.Logistic regression analysis revealed that factors such as age≥70 years,coexisting diseases,Basel Index score≤40,pain score≥4,tube slip risk assessment≥10,RASS sedation score≥3,NGASR score≥9,lost risk assessment score≥7,GCS Coma Scale score≤8,Stress Injury Assessment Scale score≤10,and Morse score≥45 were associated with the risk of adverse nursing events.In addition,inadequate awareness of nursing risks among nursing staff,ineffective patient health education methods,and non-compliance to nursing protocols were identified as primary causes of adverse nursing events.Conclusion Advanced age,combined with other diseases,and hospitalization scale assessment results are critical factors for adverse nursing events.Lack of nursing responsibility and risk awareness among nursing staff,inadequate system implementation,and irregular operations can increase the risk.Hospitals should optimize management systems and work processes,enhance nursing staff training,and develop targeted preventive measures for adverse nursing events to improve the quality of nursing management and reduce the risk of adverse nursing events.

关 键 词：护理 不良事件 对策 跌倒 

分 类 号：R197.323.4[医药卫生—卫生事业管理]