曹玉英

【摘要】 目的：探討基于JCI-IPSG标准的心内科患者安全目标持续改进的方法与效果。方法：回顾性分析2013年7-12月（启动JCI认证前）济宁医学院附属医院心内二科患者的病历资料，设置为A组（n=2 163）；回顾性分析2015年7-12月（JCI认证后）本院心内二科患者的病历资料，设置为B组（n=2 876）。A组采用常规护理措施，B组采用基于JCI-IPSG标准的综合护理措施。比较两组护理事故、护患纠纷、护理差错的发生情况、护理质量和满意度评分，以及患者身份辨识和药品使用错误、院内感染、跌倒、坠床、压疮以及其他护理不良事件的发生情况。结果：B组护理事故、护患纠纷、护理差错发生情况均明显低于A组，护理质量和满意度评分均明显高于A组，差异均有统计学意义（P<0.05）。B组患者身份辨识和药品使用错误、院内感染、跌倒发生情况均明显低于A组，差异均有统计学意义（P<0.05）。两组坠床、压疮发生情况比较，差异均无统计学意义（P>0.05）。B组其他护理不良事件发生情况明显低于A组，差异有统计学意义（P<0.05）。结论：基于JCI-IPSG标准的患者安全目标持续改进实践能够有效保障心内科患者的诊疗安全，提升护理工作质量和患者满意度，降低不良护理事件的发生率，这对于临床护理实践具有一定的借鉴意义和参考价值。

【关键词】 患者安全； 持续质量改进； JCI； 国际患者安全目标； 护理

【Abstract】 Objective：To explore the method and effect of continuous improvement of patients safety goals in Department of Cardiology based on JCI-IPSG criteria.Method：The medical records of patients in No.2 Department of Cardiology of Affiliated Hospital of Jining Medical University from July to December 2013（before JCI certification） were retrospectively analyzed and they were set up as group A（n=2 163）.The medical records of patients in No.2 Department of Cardiology of our hospital from July to December 2015（after JCI certification） were retrospectively analyzed and they were set up as group B（n=2 876）.Group A was given conventional nursing measures，group B was given comprehensive nursing measures based on the JCI-IPSG criteria.The incidences of nursing accidents，nurse-patient disputes，nursing errors， nursing quality and satisfaction scores，the incidences of identification of patients and drug use errors，nosocomial infection，falls，falling down beds，pressure sores and other care-related adverse events of two groups were compared.Result：The incidence of nursing accidents， nurse-patient disputes and nursing errors in the group B were significantly lower than those in the group A，the scores of nursing quality and satisfaction were significantly higher than those in the group A，the differences were statistically significant （P<0.05）.The incidence of identification of patients and drug use errors，nosocomial infection and falls in the group B were significantly lower than those in the group A，the differences were statistically significant （P<0.05）.There were no significant differences in the incidence of falling down beds and pressure sores between two groups （P>0.05）.The incidence of other adverse nursing events in the group B was significantly lower than that in the group A，the difference was statistically significant （P<0.05）.

Conclusion：It can effectively ensure the safety of diagnosis and treatment of patients in Cardiology，improve quality of nursing work and patients satisfaction，and reduce the incidence of adverse nursing events by continuous improvement practice of patients safety goals based on JCI-IPSG criteria，and it has certain reference significance and reference value for clinical nursing practice.

【Key words】 Patients safety； Continuous quality improvement； JCI； International patient safety goals； Nursing

First-authors address：Affiliated Hospital of Jining Medical University，Jining 272029，China

doi：10.3969/j.issn.1674-4985.2018.24.022

为进一步加强医院内涵建设、提升医疗服务水平，本院于2014年1月将“国际医院联合委员会评审标准”（Joint Commission International Accreditation Standards for Hospital，简称JCI标准）引入医疗护理服务，并于2015年7月通过了JCI认证。国际患者安全目标（International Patient Safety Goals，IPSG）是JCI评审标准的首要章节，该章节要求申请认证医疗机构的“衡量要素”需要“完全符合”评审标准，以促使患者安全的措施得到切实地改进和保障[1-2]。本文回顾性分析了JCI认证前后本院心内科护理实践工作，探讨了基于JCI-IPSG标准的心内科患者安全目标的改进效果，旨在为提高心内科患者安全与护理服务质量提供参考，现报道如下。

1 资料与方法

1.1 一般资料 回顾性分析2013年7-12月（启动JCI认证前）本院心内二科患者的病历资料，设置为A组（n=2 163）；……