张小荣　黄静　何珍娇

[摘要]目的 探討护理安全风险管理防御机制在危重急诊抢救中的影响。方法 回顾性分析2017年6～10月我院急诊科接诊的60例危重患者的临床相关资料，根据管理模式不同分为对照组和观察组，每组各30例。对照组给予常规护理，观察组在常规护理基础上行护理安全风险管理防御机制，比较两组抢救成功率、并发症发生率、护理差错率、抢救时间、心肺复苏时间、插管时间、风险事件发生情况、护理人员风险管理掌握情况及护理满意度。结果 观察组并发症发生率、护理差错率（3.33%、3.33%）均较对照组（26.67%、30.00%）低，差异有统计学意义（P<0.05）；两组抢救成功率比较，差异无统计学意义（P>0.05）；观察组抢救时间、心肺复苏时间及插管时间[（30.82±11.49）、（3.29±2.04）、（5.42±2.18）min]均较对照组[（42.67±12.95）、（5.58±2.67）、（8.26±3.12）min]短，差异均有统计学意义（P<0.05）；两组风险事件总发生率比较，观察组（6.67%）较对照组（26.67%）低，差异有统计学意义（P<0.05）；两组风险意识、风险管理认识、行为意识及态度评分比较，观察组[（22.56±2.25）、（23.68±1.29）、（21.49±2.46）、（20.18±2.47）分]较对照组[（17.92±3.54）、（18.46±4.82）、（15.96±3.58）、（14.74±4.55）分]高，差异均有统计学意义（P<0.05）；观察组满意度（93.33%）较对照组（70.00%）高，差异有统计学意义（P<0.05）。结论 在危重急诊抢救中实施护理安全风险管理防御机制应用效果显著，可有效提升护理人员风险意识，还可减少风险事件，提升满意度。

[关键词]护理安全风险管理防御机制；急诊；危重抢救

[中图分类号] R197.323 [文献标识码] A [文章编号] 1674-4721（2018）8（a）-0218-03

Effect of risk management defense mechanism on nursing safety in emergency rescue

ZHANG Xiao-rong HUANG Jing HE Zhen-jiao

Department of Nursing， People′s Hospital of Yugan County， Jiangxi Province， Yugan 335100， China

[Abstract] Objective To investigate the effect of risk management defense mechanism on nursing safety in emergency rescue. Methods The clinical data of 60 critical patients in the emergency department from June to October 2017 were retrospectively analyzed. All the patients were divided into two groups by management modes， 30 cases in each group. The control group was given routine emergency nursing， while the observation group was given risk management defense mechanism of nursing safety based on control group. The rescue success rate， incidence of complications， nursing error rate， rescue time， cardiopulmonary resuscitation time， intubation time， hospital stays， risk events， risk management of nursing staff and nursing satisfaction were compared between the two groups. Results The incidence of complications， nursing error rate in observation group [3.33%， 3.33%] were lower than that in the control group [26.67%， 30.00%] （P<0.05）. There was no statistical difference in the rescue error rate between the two groups （P>0.05）. The rescue time， cardiopulmonary resuscitation time， intubation time in the observation group （[30.82±11.49]， [3.29±2.04]， [5.42±2.18] min） were shorter than than in the control group （[42.67±12.95]， [5.58±2.67]， [8.26±3.12] min） （P<0.05）. The total incidence of risk events in the observation group （6.67%） was lower than that in the control group （26.67%） （P<0.05）. The scores of risk awareness， acquaintance of risk management， behavior consciousness， attitude in the observation group （[22.56±2.25]， [23.68±1.29]， [21.49±2.46]， [20.18±2.47] points） were higher than that in the control group （[17.92±3.54]， [18.46±4.82]， [15.96±3.58]， [14.74±4.55] points） （P<0.05）. The total satisfaction of the observation group （93.33%） was higher than that in the control group （70.00%） （P<0.05）. Conclusion The application of risk management defense mechanism of nursing safety in emergency rescue is effective， it can increase the risk awareness of nursing staff， reduce risk events and promote satisfaction.

[Key words] Risk management defense mechanism of nursing safety； Emergency； Emergency rescue

急诊科在医院中的占据重要位置，也是重症患者最集中、抢救与管理任务最重、病种最多的科室，急诊科患者具有病情复杂、病情变化快等特点，危重患者应尽早接受准确的诊疗及救治，抢救时需迅速、敏捷，稍有延误即可能错过最佳抢救时机，同时，还受到医疗条件、护理方面等多种因素的影响，对患者的生命安全造成影响[1-3]。近年来，急诊室发生的医疗安全事故不断，护理安全风险管理防御机制在保障患者生命安全中起到十分关键的作用[4]。因此，及时为急诊重症患者提供专业、科学、有效等护理功能，在减少护理差错、弥补护理缺陷及提升急救水平中均具有重要意义。……