影响血液净化护理安全管理因素的分析和应对策略.docVIP

影响血液净化护理安全管理因素的分析和应对策略 　　doi：10.3969/j.issn.1007-614x.2014.20.84 　　摘 要 目的：探讨血液净化护理安全管理因素及应对措施。方法：2013年1月-2013年12月收治行血液净化患者，共计12 467例次，分析血液净化护理安全管理因素。结果：本组发生176例次护理不良事件，发生率1.41%。低血压、失衡综合征、肌肉痛性痉挛等并发症75例，焦虑、抑郁等不良情绪39例，穿刺内瘘血肿、出血34例，治疗告知未及时记录16例，穿刺针管因素12例。分析原因与护士责任心不强、患者安全管理不到位、违反操作流程、环境安全意外等多种因素有关。结论：血液净化室要严格执行核心制度及操作流程，加强环节管理，加强专科知识及心理素质培训，保证血液净化治疗安全进行。 　　关键词 血液净化 护理安全 护理措施 安全隐患 　　Analysis and countermeasures of management factors affecting blood purification nursing safety 　　Yang Zeman 　　The Peoples Hospital of Chaozhou City，Guangdong 521011 　　Abstract Objective：To explore the management factors affecting blood purification nursing safety and countermeasures.Methods：12467 cases with blood purification were selected from January 2013 to December 2013.We analyzed the nursing safety management factors in blood purification.Results：In this group，there were 176 cases of nursing adverse events.The occurence rate was 1.41%.Complications occurred in 75 cases，including hypotension，disequilibrium syndrome，muscle cramps and so on. 39 cases ad anxiety，depression and other negative emotions.34 cases had hemorrhage and hematoma puncture fistula.Treatment of that had not been recorded in 16 cases.12 cases had puncture needle factors.The reason was related to many factors，including not strong responsibility heart of nurses，patient safety management not in place，the violation of operating process，environment and safety accident and so on.Conclusion：Blood purification room should strictly implement the core system and process，strengthen the management，strengthen the professional knowledge and psychological quality training，to ensure the safety of blood purification therapy. 　　Key words Blood purification；Nursing safety；Nursing measures；Hidden danger 　　护理安全是护理过程中患者不出现法定的规章制度和法律允许范围外的机体结构、功能、心理上的缺陷、障碍或死亡[1]，是反映护理质量的重要标准，也是衡量医院管理水平的基础。本文对影响血液净化的相关因素进行分析，并制定采取相应的应对策略，现报告如下。 　　资料与方法 　　2013年1月-2013年12月收治行血液净化患者，共计12 467例次，其中发生护理不良事件176例次，入选患者符合我国医药卫生相关法规、国家卫生部颁布的《医疗护理操作技术规范》[2