王小英

[摘要]目的 探讨呼吸科危重症患者应用护理风险管理模式的效果，并进行护理后的效果比较。方法 选取2014年2月～2016年11月来我院呼吸内科治疗的78例患者，随机分为对照组（n=39）和观察组（n=39）。对照组行常规护理，观察组行护理风险管理，观察并记录患者的临床症状、患者满意度及护理效果。结果 观察组患者的呼吸频率、心率及pH值与对照组相比更加稳定，患者的呼吸状态相对更好，差异有统计学意义（P<0.05）；观察组患者非计划性拔管、护患间纠纷及意外事件发生率比对照组更低，差异有统计学意义（P<0.05）；观察组患者及家属满意度为97.4%，远超对照组患者及家属满意度（84.6%），差异有统计学意义（P<0.05）；观察组患者总有效率（94.8%）远高于对照组患者（79.5%），差异有统计学意义（P<0.05）。结论 呼吸内科危重症患者应用护理风险管理模式进行护理效果优异，能够有效减少护理风险、提高护理的安全性，值得在临床护理中推广使用。

[关键词]护理风险管理；呼吸频率；危重症患者；护理效果

[中图分类号] R473.5 [文献标识码] A [文章编号] 1674-4721（2017）07（c）-0122-03

Effect observation on nursing risk management in critically ill patients with respiratory disease

WANG Xiao-ying

Department of Respiratory Medicine，the Affiliated Hospital of Jiujiang College，Jiangxi Province，Jiujiang 332000，China

[Abstract]Objective To discuss the effect of nursing risk management in critically ill patients with respiratory disease and to compare the effect of nursing care.Methods 78 patients who received respiratory medicine from our hospital in February 2014 to November 2016 were randomly divided into control group（n=39） and observation group（n=39）.Patients in the control group were given routine nursing，while those in the observation group were given nursing risk management.The clinical symptoms，patients′satisfaction and nursing effects were observed and recorded.Results The respiratory rate，heart rate and pH value of patients in the observation group were more stable than those in the control group，and the patient′s breathing state was relatively better，with statistically significant differences（P<0.05）.The incidence rates of unplanned extubation，nurse-patient disputes，and accidents were significantly lower in the observationgroup after nursing risk management than those in the control group（P<0.05）.The satisfaction rate of patients and their families was 97.4% in the observation group after nursing risk management，significantly higher than thatin the control group（84.6%，P<0.05）.The overall response rate in the observation group（94.8%）was significantly higher than that in the control group（79.5%，P<0.05）.Conclusion Application of nursing risk management in critically ill patients with respiratory disease is excellent in nursing effect，which can effectively reduce the nursing risk and improve the safety of nursing，thus is worthy to be promoted in clinical practice.

[Key words]Nursing risk management；Respiratory rate；Critically ill patients；Nursing effect

呼吸科危重癥患者的临床表现多为呼气性呼吸困难、咳嗽、咳痰等症状，由于患者年龄较大，痰液黏稠，不易咳出，症状处理不及时会引发生命危险或异常病症[1-3]。为提高护理的优质化服务，营造舒适安全的护理环境，进一步减轻患者的病痛折磨，防止病情加重等，我院采取现代护理理念—护理风险模式，收到了较好的效果，现报道如下。

1资料与方法

1.1一般资料

从2014年2月～2016年11月来我院呼吸内科治疗的患者中随机选择78例，所有患者因病情严重均于重症监护室救治。临床表现为喘息、气急、胸闷、咳嗽、呼吸困难等症状，所有患者具有≥两种上述病症。所有患者随机分为两组，观察组39例，男21例，女18例，年龄53.2～78.9岁，平均年龄（60.3±4.5）岁，哮喘13例，慢性肺源性心脏病16例，慢性阻塞性肺病10例；对照组39例，男24例，女15例，年龄56.7～79.2岁，平均年龄（62.6±5.2）岁，哮喘10例，慢性肺源性心脏病10例，慢性阻塞性肺病19例。两组在年龄、病种等方面差异无统计学意义（P>0.05），具有可比性。……