“床旁交班五项”在儿童神经科床旁交接班中的使用.docVIP

“床旁交班五项”在儿童神经科床旁交接班中的使用 　　[摘要] 目的 分析护士传统床旁交接班模式存在的问题并进行改进，对比改进前后的交接班效果。 方法 2013年1～12月首都医科大学宣武医院儿科采用传统交接班模式完成了432人次交接，采用根因分析法，从人员、机器/设备、材料、方法/管理、环境5个方面对传统床旁交接班模式中出现的问题进行原因分析，并提出改进后接班模式――床旁交班五项。2014年1～12月采用改进后交接班模式完成了434人次交接。以病情重点突出、病情条理清晰、检查情况交接到位、管路交接清楚、日常生活能力评定、跌倒/坠床风险评估、压疮风险评估、疼痛评估、各类给药交接为评价指标，对比改进前后交接班的效果。 结果 与传统交接班模式比较，采取改进后交接班模式后，护士在病情重点突出、病情条理清晰、检查情况交接到位、管路交接清楚、日常生活能力评定、跌倒/坠床风险评估、压疮风险评估、疼痛评估、各类给药交接方面均明显提高，差异均有高度统计学意义（P 0.01）。同时在床旁交接班中，护士变被动为主动，护士从对患儿病情的充分了解、动态细化的风险评估、针对护理及安全问题给予有效的护理措施这一工作流程得到了落实。 结论 改进后的床旁交接班模式使交接班更加规范、合理，有利于护理工作质量的持续提高。 　　[关键词] 床旁交接班；交接班模式；护理质量 　　[中图分类号] R197.324 [文献标识码] A [文章编号] 1673-7210（2016）03（b）-0166-05 　　[Abstract] Objective To analyze and improve the traditional bedside-shift exchange model and compare the effect of the shift exchange model before and after improved. Methods From January to December 2013， 432 patients were given the traditional bedside-shift model in the Department of Pediatrics of Xuanwu Hospital Capital Medical University， and the root cause analysis was applied to identify problems in the traditional bedside-shift model in five aspects： personnel， machines/equipment， materials， methods/management and environment， and a optimized bedside-shift model was put forward， called five principles of bedside-shift. A total of 434 patients were given the optimized bedside-shift model from January to December 2014. The effect of two kinds of bedside-shift model was evaluated in patients condition highlight， well-organized of patients condition， well shift of inspection， clear pipeline management， daily life activity function assessment， risk assessment of fall/drop of bed， risk assessment of pressure ulcer， pain assessment， and drug administration. Results Compared with the traditional bedside-shift change model， patients condition highlight， well-organized of patients condition， well shift of inspection， clear pipeline management， daily life activity function assessment， risk assessment of fall/drop of bed， risk asse