以四重目标理论为指导同质化管理急诊跨科收治患者的效果评价

doi:10.3761/j.issn.2096-7446.2024.11.004

摘要/Abstract

摘要： 目的以四重目标理论为指导实施急诊患者跨科收治同质化护理管理并进行应用效果评价。方法成立研究小组,开展急诊跨科同质化管理培训及管理。选取2022年1月—6月于杭州市某三级甲等医院急诊跨科收治的患者为试验组（n=915）,2021年7月—12月常规护理患者为对照组（n=917）,比较两组的护理质量安全指标（全院急救紧急呼叫系统启动、快速反应小组启动、给药错误、坠床跌倒、压力性损伤例数）以及效率指标（首次开具医嘱时间、平均住院日、患者和医生对护士的满意度）。结果与对照组相比,试验组紧急呼叫系统启动率、快速反应小组启动率、给药错误、坠床跌倒、压力性损伤例数均下降;首次开具医嘱时间缩短（P<0.001）;相近病种平均住院日显著下降（P=0.003）;患者及医生对护士满意度均显著增高（P<0.001）。结论应用四重目标关键因素建立的急诊患者跨科收治同质化护理管理方法,有助于改善护士对患者的安全管理及效率管理,同时提高急诊跨科患者及主管医生对护士的满意度。

关键词: 急诊患者, 跨科收治, 四重目标理论, 同质化, 安全管理, 效率管理

Abstract: Objective Guided by the quadruple Objective theory,to establish a homogeneous nursing management method for cross-disciplinary admission of emergency patients,and evaluate its application effect. Methods A research group was established to conduct unified training on homogenization of cross-department management for emergency patients. The patients admitted to cross-departments from the emergency department of a tertiary hospital in Hangzhou from January to June 2022 were selected as the experimental group（n=915）,and the patients admitted from July to December 2021 was retrospectively analyzed as the control group（n=917） and received the routine nursing. The nursing quality and safety indicators,such as the hospital-wide emergency call system（999） and rapid response team（RRT） initiation,medication errors,bed falls,and pressure injuries,efficiency indicators such as the time to first doctor‘s order issued,the average length of hospital stay,and the satisfaction of patients and doctors with nurses,were compared between the two groups. Results Compared with the control group,the safety and quality indicators of nursing management including the 999 initiation rate and RRT initiation rate,medication errors,bed falls and pressure injuries were decreased in the experimental group. In terms of efficiency management,the time for the first order issued by the specialist in charge was shortened（P<0.001）. The average length of hospital stay for similar diseases decreased significantly（P=0.003）. The satisfaction of patients and doctors with nurses was significantly increased（all P<0.001）. Conclusion The application of quadruple Objective theory to construct a homogenized nursing management for emergency patients‘ cross-department treatment contributes to improving nurses‘ safety management and efficiency management,and the satisfaction of emergency patients and doctors with nurses.

Key words: Emergency Patients, Cross-Disciplinary Admission, Quadruple Objective Theory, Homogenization, Safety Management, Efficiency Management

曹俊华, 周莉莉, 杨旻斐, 吴小燕, 赵金凤, 黄红燕. 以四重目标理论为指导同质化管理急诊跨科收治患者的效果评价[J]. 中华急危重症护理杂志, 2024, 5(11): 985-990.

CAO Junhua, ZHOU Lili, YANG Minfei, WU Xiaoyan, ZHAO Jinfeng, HUANG Hongyan. Effect evaluation of homogeneous nursing management for cross-disciplinary admission of emergency patients under the quadruple objective theory[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(11): 985-990.

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