ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 >

2024 , Vol. 5 >Issue 11: 985 - 990

DOI: https://doi.org/10.3761/j.issn.2096-7446.2024.11.004

多学科协作专题

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

  • 曹俊华 ,
  • 周莉莉 ,
  • 杨旻斐 ,
  • 吴小燕 ,
  • 赵金凤 ,
  • 黄红燕
展开
  • 310009 杭州市 浙江大学医学院附属第二医院护理部（曹俊华）,心血管内科（周莉莉）,急诊室（杨旻斐）,全程管理中心（吴小燕,赵金凤,黄红燕）
曹俊华：女,硕士,副主任护师,护士长,E-mail：2319068@zju.edu.cn

收稿日期: 2024-01-18

  网络出版日期: 2024-12-03

基金资助

浙江省教育厅一般科研项目（Y202043422）

收起

Effect evaluation of homogeneous nursing management for cross-disciplinary admission of emergency patients under the quadruple objective theory

  • CAO Junhua ,
  • ZHOU Lili ,
  • YANG Minfei ,
  • WU Xiaoyan ,
  • ZHAO Jinfeng ,
  • HUANG Hongyan
Expand
  • Nursing Department,The Second Affiliated Hospital Zhejiang University School of Me-dicine,Hangzhou, 310009,China

Received date: 2024-01-18

  Online published: 2024-12-03

Fold

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

本文引用格式

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 . DOI: 10.3761/j.issn.2096-7446.2024.11.004

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

参考文献

[1] 徐春芳. 急诊拥挤状态下SHEL管理模式在滞留患者中的应用[J]. 心理月刊,2020,15(10):40,42.
Xu CF. Application of SHEL management mode in the emergency crowded state in the detention patients[J]. J Psychol,2020,15(10):40,42.
[2] 郑威,吴占勇,吴春富,等. 跨科共享病床资源管理[J]. 解放军医院管理杂志,2019,26(4):354-357.
Zheng W,Wu ZY,Wu CF,et al.Management of rational distribution of hospital beds inter-department sharing[J]. Hosp Adm J Chin PLA,2019,26(4):354-357.
[3] 叶志弘,王菊香. 立体收住病人的实施与护理应对[J]. 中华护理杂志,2003,38(3):196-198.
Ye ZH,Wang JX.Discussion effects upon patient care in units with subspecialties[J]. Chin J Nurs,2003,38(3):196-198.
[4] 徐玉莲,叶志弘,黄红波. 医院跨科收住患者的风险管理[J]. 中华护理杂志,2014,49(12):1491-1494.
Xu YL,Ye ZH,Huang HB.Risk management of multiple dimensional patients‘ admission[J]. Chin J Nurs,2014,49(12):1491-1494.
[5] 康福娟,史秀娥,殷哲,等. 护理风险管理在急诊科护理管理中的应用[J]. 实用临床护理学电子杂志,2018,3(9):146,155.
Kang FJ,Shi XE,Yin Z,et al. Application of nursing risk management in nursing management of emergency department[J]. J Clin Nursing‘s Pract,2018,3(9):146,155.
[6] 袁玉仙,祝鸣兰,杨媛,等. 基于风险管理的全院床位资源共享跨科收治的探索与实践[J]. 中国卫生标准管理,2023,14(1):91-96.
Yuan YX,Zhu ML,Yang Y,et al.Exploration and practice of cross disciplinary admission based on risk management and sharing of bed resources in the whole hospital[J]. China Health Stand Manag,2023,14(1):91-96.
[7] 张硕,梅宇欣,刘昊,等. 贯彻医疗服务标准促进医疗服务同质化建设[J]. 中国医疗管理科学,2015,5(2):40-42.
Zhang S,Mei YX,Liu H,et al.Implementing medical service standards,promoting medical service homogenization[J]. Chin J Med Manag Sci,2015,5(2):40-42.
[8] Bodenheimer T,Sinsky C.From triple to quadruple aim:care of the patient requires care of the provider[J]. Ann Fam Med,2014,12(6):573-576.
[9] Bachynsky N.Implications for policy:the Triple Aim,Quadruple Aim,and interprofessional collaboration[J]. Nurs Forum,2020,55(1):54-64.
[10] 杨玥含,刘清杰. 探讨跨科收治患者的护理风险干预[J]. 微量元素与健康研究,2018,35(3):81,83.
Yang YH,Liu QJ. Objective:to explore the nursing risk intervention of patients admitted across departments[J]. Stud Trace Elem Health,2018,35(3):81,83.
[11] Motlatla M,Maluleke TX.Assessment of knowledge about healthcare risk waste management at a tertiary hospital in the northern cape province,South Africa[J]. Int J Environ Res Public Health,2021,18(2):449.
[12] 毛强,曾程慧,雷鹏,等. 基于DEA-BCC模型的临床科室医疗服务效率分析[J]. 中华医院管理杂志,2020,36(9):734-738.
Mao Q,Zeng CH,Lei P,et al.Analysis of medical service efficiency of clinical departments based on data envelopment analysis-BCC model[J]. Chin J Hosp Adm,2020,36(9):734-738.
[13] 付涛,胡欣,石小姑. 差异化培训在提高跨科护理能力中的应用[J]. 中国乡村医药,2020,27(3):67.
Fu T,Hu X,Shi XG.Application of differentiated training in improving interdisciplinary nursing ability[J]. Chin J Rural Med Pharm,2020,27(3):67.
[14] 任建凤,王一龙,贺学敏,等. 同质化管理对ICU护士临床实践能力及患者安全的影响[J]. 中华现代护理杂志,2018,24(15):1837-1840.
Ren JF,Wang YL,He XM,et al.Effects of homogeneity management on ICU nurses‘ clinical practice ability and patient safety[J]. Chin J Mod Nurs,2018,24(15):1837-1840.
[15] 李金蕊,李春红,李盼,等. 同质化管理在区域医疗联合体护理质量改进中的应用[J]. 中华现代护理杂志,2018,24(5):603-605.
Li JR,Li CH,Li P,et al.Application of homogenizing management in the improving of nursing quality in regional medical consortium[J]. Chin J Mod Nurs,2018,24(5):603-605.
[16] 王建安. 浙大二院:加快推进“效率医疗”改革[J]. 中国医院院长,2020,16(22):88-90.
Wang JA.The Second Hospital of Zhejiang University:accelerating the reform of “efficient medical care”[J]. China Hosp CEO,2020,16(22):88-90.
[17] 宁世伟,张瑞迪,张丽华. 临床科室平均住院日目标值个性化调整路径探讨[J]. 中国医院管理,2022,42(1):53-56.
Ning SW,Zhang RD,Zhang LH.Discussion on the personalized adjustment path of average stay days target in clinical departments[J]. Chin Hosp Manag,2022,42(1):53-56.
[18] 于海跃,沈婷,马艺瑗,等. 中心化平均住院日和标准化平均住院日有效性研究[J]. 中国医院管理,2023,43(11):38-43.
Yu HY,Shen T,Ma YY,et al.Research on the effectiveness of centralized average hospital length of stay and normalized hospital average length of stay[J]. Chin Hosp Manag,2023,43(11):38-43.
[19] 刘诗洋,陈吟,孙静,等. 不同类型医院住院患者满意度影响因素分析[J]. 中华医院管理杂志,2018,34(2):99-103,109.
Liu SY,Chen Y,Sun J,et al.Multivariate analysis of influencing factors of inpatients‘ satisfaction in hospitals of different types[J]. Chin J Hosp Adm,2018,34(2):99-103,109.
[20] 金晓凤,吴晓艳,陶蓉. 住院患者满意度影响因素研究进展[J]. 解放军医院管理杂志,2020,27(3):227-229.
Jin XF,Wu XY,Tao R.Research progress on influencing factors of inpatient satisfaction[J]. Hosp Adm J Chin PLA,2020,27(3):227-229.
[21] 黄丽,杜玉芳. 医护人员同理能力评估方法的研究进展[J]. 中华护理杂志,2008,43(8):743-746.
Huang L,Du YF.Research progress on empathy evaluation methods for medical staff[J]. Chin J Nurs,2008,43(8):743-746.
Options
文章导航

/

〈 〉