【摘要】 目的 探讨护理不良事件报告机制的构建与完善情况。 方法 根据护理工作不良事件发生的类别、范围，确定不良事件报告原则，报告程序，构建护理不良事件报告机制。 结果 护理不良事件申报机制形成后，院内护理不良事件发生率及重复发生率逐月下降、主动申报率上升，与构建护理不良事件报告机制前一年比较，差异有统计学意义（Plt;0.05）。 结论 护理不良事件报告机制有助于护理安全管理。【Abstract】 Objective To investigate the construction and improvement of reporting system of nursing adverse events. Methods According to the types and scales of the nursing adverse events, reporting principles and procedures were confirmed, and the reporting system of nursing adverse events was constructed. Results The rates of nursing adverse events and repetition incidence decreased gradually and the rate of initiative declaring increased significantly compared with those one year before the construction of the reporting system (Plt;0.05). Conclusion Reporting system of nursing adverse events helps to improve the management of nursing security.
ObjectiveTo design and use adverse nursing events information management system to improve the quality of nursing for high-risk patients and guarantee nursing quality and safety. MethodAdverse nursing events information management system was started from January 2014. Two hundred cases assessed to be nursing adverse events cases from September to December 2013 were chosen to form the control group, and another 200 from the same period in 2014 were designated to be the observation group. Then we compared the two groups in terms of the onset time of nursing assessment, incidence of adverse nursing events and rate of missing reports. ResultsThe onset time of nursing assessment, incidence of adverse events, and the rate of missing reports were significantly lower in the observation group than the control group (P<0.05). ConclusionsThe application of adverse nursing events information management system can improve the quality of nursing management and promote the nursing quality and safety.
ObjectiveTo explore the application and effect of root cause analysis (RCA) in the management of adverse nursing events. MethodsNursing staff members were trained to establish the team of root cause analysis. They collected related materials of adverse nursing events in the infusion room of the Department of Pediatrics, found out the proximal causes and root causes, developed and implemented the corrective measures. RCA was carried out between January 2013 and December 2014. The efficacy was evaluated and the adverse events rate was compared before and after the practice. ResultsAfter the performance of RCA, the reporting rate of adverse events increased, the rate of adverse events decreased, and the reporting rate of potential safety problems also increased. All those changes were significant (P<0.01). ConclusionRoot cause analysis can decrease the rate of adverse nursing events, raise the reporting rate of adverse events. It is an effective guarantee to improve the nursing safety management.