黄海英 姚玉花

【摘要】 目的：分析精細化管理在预防坠床/跌倒护理不良事件中的应用及可行性。方法：回顾性分析2017年5月-2018年5月笔者所在医院收治的158例住院患者的临床资料，按照管理方式的不同将其分为对照组和试验组，各79例。对照组给予常规管理进行干预，试验组给予精细化管理进行干预。比较两组坠床/跌倒护理不良事件发生率、护理质量评分、住院时间、住院费用、护理满意度。结果：试验组患者出现坠床、跌倒不良事件发生率明显低于对照组，差异均有统计学意义（P<0.05）。试验组护理质量评分明显高于对照组，住院时间明显短于对照组，住院费用明显低于对照组，差异均有统计学意义（P<0.05）。试验组护理总满意率为97.47%，高于对照组的83.54%，试验组满意度评分明显高于对照组，差异均有统计学意义（P<0.05）。结论：给予住院患者进行精细化管理，可明显降低坠床/跌倒护理不良事件发生率，明显提高患者满意率，具有极高的可行性。

【关键词】 精细化管理 护理不良事件 可行性

doi：10.14033/j.cnki.cfmr.2019.30.051 文献标识码 B 文章编号 1674-6805（2019）30-0-03

[Abstract] Objective： To analyze the application and feasibility of fine management in preventing falling bed/falling nursing adverse events. Method： The clinical data of 158 hospitalized patients admitted in our hospital from May 2017 to May 2018 were retrospectively analyzed. They were divided into the control group and the experimental group according to different management methods， with 79 cases in each group. The control group was intervened by routine management， while the experimental group was intervened by fine management. The incidence of adverse events， nursing quality score， hospitalization time， hospitalization expenses and nursing satisfaction were compared between the two groups. Result： The incidence of adverse events of falling bed and falling in the experimental group was significantly lower than that in the control group， the difference was statistically significant （P<0.05）. The nursing quality score of the experimental group was significantly higher than that of the control group， and the hospitalization time was significantly shorter than that of the control group， and the hospitalization expenses was significantly lower than that of the control group， the differences were statistically significant （P<0.05）. The total nursing satisfaction rate of the experimental group was 97.47%， which was higher than 83.54% of the control group， and the satisfaction score of the experimental group was significantly higher than that of the control group， the differences were statistically significant （P<0.05）. Conclusion： Fine management of hospitalized patients can significantly reduce the incidence of adverse events in fall bed/fall nursing， and significantly improve the satisfaction rate of patients， which has a very high feasibility.

[Key words] Fine management Nursing adverse events Feasibility

First-authors address： Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou 350000， China

在康复医院，患者常因脑卒中、脑出血、颈腰椎疾病等原因造成肢体活动功能障碍，多数患者年龄大且并发一种或多种慢性疾病，如糖尿病、高血压等。坠床/跌倒等不良事件在临床治疗中常常发生，高危环节如：在刚入院时，患者坠床/跌倒防范意识较差，容易发生坠床/跌倒;住院三周或以上的患者，功能有不同程度的恢复，自我自理能力评估太高，各种动作希望自己完成，常常不请人协作而坠床/跌倒;夜间、护工或家属离开时，患者不好意思麻烦护士，取物、如厕时发生坠床/跌倒，上述不良事件的发生不仅会加重患者病情，而且易引起医患纠纷[1-2]。然而，精细化管理是一种符合现代医院护理的管理模式，其应用科学、合理的医疗资源，全面提升护理服务质量[3]。同时有研究报道，在坠床/跌倒高危科室（神经康复科、骨伤康复科）护理管理中应用精细化管理效果极佳，明显降低坠床/跌倒不良事件发生率[4-5]。……