张春芳 胡元 罗淑清

【摘要】 目的：研究持續质量改进式护理对急诊患者身心感受及自尊水平的影响。方法：选取笔者所在医院2016年1月-2019年1月收治的急诊患者120例进行研究。按照就诊单双号将其等分为改进组和对照组，每组60例。对照组实施常规护理，改进组则实施持续质量改进式护理。比较两组护理服务质量、干预前后身心感受、自尊水平及皮质醇、IL-6水平。结果：改进组急救技术不规范、操作不规范、护理风险意识滞后、监护力度较差发生率低于对照组，差异有统计学意义（P<0.05）。干预后两组SPB评分均较干预前降低，且改进组低于对照组，差异有统计学意义（P<0.05）。干预后两组RSES评分均显著高于干预前，且改进组显著高于对照组，差异有统计学意义（P<0.05）。干预后改进组皮质醇、IL-6水平均低于对照组，差异有统计学意义（P<0.05）。结论：持续质量改进式护理可显著改善急诊患者身心感受及自尊水平，同时有利于减轻患者的应激反应程度，值得临床推广应用。

【关键词】 急诊患者 持续质量改进 身心感受 自尊水平 护理干预

doi：10.14033/j.cnki.cfmr.2020.19.041 文献标识码 B 文章编号 1674-6805（2020）19-0-03

Analysis of the Effects of Continuous Quality Improvement Nursing on Physical and Mental Feelings and Self-esteem Level of Emergency Patients/ZHANG Chunfang， HU Yuan， LUO Shuqing. //Chinese and Foreign Medical Research， 2020， 18（19）： -104

[Abstract] Objective： To study the effects of continuous quality improvement nursing on physical and mental feelings and self-esteem level of emergency patients. Method： A total of 120 emergency patients admitted in our hospital from January 2016 to January 2019 were selected for study. The patients were equally divided into the improved group and the control group according to odd and even number， with 60 patients in each group. The control group received routine nursing， while the improved group received continuous quality improvement nursing. The nursing service quality， physical and mental feelings， self-esteem level and cortisol and IL-6 levels before and after intervention were compared between the two groups. Result： The incidence of non-standard first aid technique， non-standard operation， delayed nursing risk awareness， and poor monitoring in the improved group were lower than those in the control group， and the differences were statistically significant （P<0.05）. After intervention， the SPB score of both groups was lower than that before intervention， and that of the improved group was lower than that of the control group， and the difference was statistically significant （P<0.05）. After intervention， the RSES score of both groups was significantly higher than that before intervention， and the improved group was significantly higher than the control group， and the difference was statistically significant （P<0.05）. After intervention， cortisol and IL-6 levels in the improved group were lower than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion： Continuous quality improvement nursing can significantly improve the physical and mental feelings and self-esteem level of emergency patients， and help to reduce the degree of stress response of patients. It is worthy of clinical application.

[Key words] Emergency patients Continuous quality improvement Physical and mental feelings Self-esteem level Nursing intervention

First-authors address： Yantian Branch， Shenzhen Yantian District Peoples Hospital， Shenzhen 518083， China

急診科是组成城市急救网络的重要部分之一，亦是各级医疗机构中抢救患者生命的重要场所，肩负着出现场抢救及院内抢救观察的多重任务[1]。而急诊护理属于急诊科重要工作内容之一，护理治疗的优劣及护理服务水平的高低会直接影响急诊患者的救治成功率，同时直接关系患者的生命健康安全、家庭完整性及社会稳定[2-3]。急诊患者往往存在病情复杂多变的特点，具有较大的医疗护理风险，而在临床实际工作中，急诊医师往往是开具临时或长期医嘱，由护理人员具体实施更多的诊疗操作[4]。因此，重视并加强急诊科护理管理，持续优化急诊科护理质量显得尤为重要，亦是目前急诊科医务人员共同关注的热点。鉴于此，本文通过研究持续质量改进式护理对急诊患者身心感受及自尊水平的影响，旨在探寻最佳干预措施，现报道如下。……