质量持续改进在眼科住院患者跌倒预防中的应用范例.doc

作者单位：225400 江苏省泰兴市人民医院18区 通讯作者：郭建雄，Email:guo.jian xiong@163.com 质量持续改进在眼科住院患者跌倒预防中的应用 【摘要】 目的　探讨护理质量持续改进对防控眼科住院患者跌倒的影响。方法　成立科室防跌倒项目质量持续改进小组，注重专科特点，引入“知信行”理论，提高医患认知，协调配合，按照评估、告知、预防、救治、改进的安全管理程序实施预见性、针对性护理，有效防控跌倒风险。比较质量持续改进前（２０１１—２０１２年）和改进后（２０１３年１月—２０１４年６月）住院患者意外跌倒发生率和护理质量。结果　改进前住院患者意外跌倒发生率０．２７％（７／２５６９），改进后无一例跌倒发生（χ２ ＝６．５０，Ｐ＜００５）；改进后护士宣教率和执行率分别为１００％和９７．５２％，患方知晓率、执行率及满意度分别为９１９８％，９０．０１％，９８．４９％，均高于改进前，差异有统计学意义（χ２ 值分别为２２４．６７，７８．０９，５８．３７，２５６７０，１３５．５６；Ｐ＜０．０１）。结论　运用护理程序，开展护理质量持续改进，提高安全意识，改进认知和行为，可有效防控眼科住院患者意外跌倒事件的发生，提高护理质量，患者安全和满意度。 [关键词] 　眼科；　住院患者；　跌倒；　安全管理；　护理质量持续改进 【Abstract】Objective To investigate the effect of continuous quality improvement of ?nursing quality on the prevention and control of hospital patients’ fall in Department of ophthalmology. Methods The team of continuous quality improvement of fall prevention was founded in 2013, which was based on the characteristic of Department of ophthalmology. It lays emphasis on the theory of KABP, the doctors and patients’ cognition and coordination ability. It provides predictable and targeted nursing service to lower the risks of patients’ fall. Results Make a retrospective analysis of the 2569 cases of Ophthalmology inpatients from 2011 to 2012 and those 2382 cases from January of 2013 to June of 2014, we can find that 7cases (which is 0.27%) of patients’ fall happened before the improvement, while 0 case occurred after the improvement（P < 0.05）. The mission rate and implementation rate increased from 91.01%, 91.83% to 100%, 97.52% respectively. The patients’ awareness rate, implementation rate and satisfaction rate added up to 91.08%, 90.01% and 98.49% from 85.01%, 72.01% and 91.01%, the differences were statistically significant（P < 0.01）. Conclusions During the nursing procedure, improving the nursing quality continuously, promoting safety awareness and improving the cognitive, could lower the risks of ophthalmic patients’ fall, improve the nursing quality and improve patients’ safety and satisfaction. [Key word