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      管理.教育.教學

      呼叫鈴聯合輸液多組登記表在急診輸液室應用與效果評價

      王慧1 郭慧芳2 林冬梅1* 李玖明3 徐國君2 周玲1

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      【摘要】  【摘要】目的 評價呼叫鈴聯合輸液多組登記表在急診輸液室的應用效果。方法 2019年4月便利抽樣法選取大連醫科大學附屬第一醫院急診輸液室患者303例為研究對象,按照計算機數字隨機分為改良組和對照組,各觀察1周。改良組采用在輸液椅扶手上安裝一鍵式呼叫鈴再聯合輸液多組登記表的方法共163例患者,對照組采用患者自主呼喊護士的傳統方法共140例患者,

      【關鍵字】  設備設計,呼叫鈴,登記表,輸注

      中圖分類號:文獻標識碼:文章編號:

      [Abstract]Objective To evaluate the application effect of infusion chair call bell combined with multi group registration form in emergency infusion room. Methods In April 2019, 303 patients in the emergency infusion room of the first affiliated hospital of Dalian medical university were randomly divided into the improved group and the control group according to computer numbers and observed for one week each. In the improved group, a total of 163 patients were installed on the armrest of the infusion chair call bell and then combined with the registration form of multiple infusion groups, while in the control group, a total of 140 patients were selected by the traditional method of patients calling for nurses. To compare two groups of patients the total satisfaction of nurses and nurse for batch a transfusion patients replacing infusion bag round trips, time-consuming, and the nurse human economic costs. In 2019 and 2017, due to the delayed response of nurses the long-term nursing service effect is not satisfied .Results Compared with the observation group, the total satisfaction of patients in the improvement group, the round-trip times and time per change of infusion bag, and the labor and economic cost of nurses were respectively [95.4%(156/163)VS 87.8%(123/140), χ2=40.40, P=0.000], [(2±1)times VS (3±1)times, Z=7.598, P=0.000], [(7.32±1.69)s VS (39.85±10.93)s, t=23.492, P=0.000], [(135.52±0.51)yuan VS (247±2.36)yuan, t=347.721, P=0.000],the difference between the two groups was statistically significant (P<0.05).Due to the delayed response of nurses, there were unsatisfactory service conditions, such as the delayed needle-pulling and excessive blood returning, the delayed infusion and pain caused by leakage of infusion, the re-puncture caused by wrong needle pulling, the anxiety of patients caused by the blocked pipeline, and the panic caused by the empty liquid bag, respectively[0.03%(12/46137)VS 0.16%(53/33101), χ2=42.211,P=0.000]; [0.01%(6/46137)VS 0.13%(44/33101), χ2=42.889, P=0.000]; [0.00%(2/46137)VS 0.04%(12/33101), χ2=11.110, P=0.001]; [0.02%(8/46137)VS 0.08%(25/33101), χ2=15.660, P=0.000]; [0.03%(12/46137)VS 0.09%(30/33101), χ2=15.175, P=0.000], the difference between the two groups was statistically significant (P<0.05). Conclusion The method of call bell combined with multi group registration form of infusion can ensure the safety of patients' intravenous infusion and improve the total satisfaction rate of patients to nursing service. Optimize the work flow of nurses, improve the work efficiency of nurses, reduce the intensity of nurses' work and save labor and economic cost.

      急診輸液室是反映急診護理工作的一個重要窗口,患者的就醫感受直接影響醫院的聲譽,隨著醫學的發展與社會的進步,患者對于護理質量和治療安全等方面提出更高的要求[1],如果處理不好患者的迫切需求很容易會引起護患糾紛。尤其是在急診輸液室的輸液高峰時段和突發批量應急輸液時,護士工作負荷加重。由于輸液診室常常人滿為患,環境嘈雜,護士需不斷接診行靜脈輸液操作,還要頻繁巡視來回折返取藥、配置、換液、拔針,同時處理患者的各種需求應答,短時間內要完成大量的治療和護理工作,單憑科室力量即使采用柔性管理以及護士的彈性排班,人力資源還是略顯不足[2],甚至需要護理部臨時調動人力資源才能解決急需。但往往難免因護士不能在第一時間應答患者需求導致拔針延遲使靜脈回血過長、輸液滲漏致疼痛延時、誤拔針致重新穿刺、管路不通致焦慮、藥液袋滴空致恐慌等服務不滿狀況。目前雖然國內有少數醫院輸液室安裝了呼叫鈴[1,3-4],但僅憑單一模式還是存在一些弊端,若配備高端的呼叫移動系統,投資成本又太高?;谝陨显?,我院急診輸液室在輸液椅扶手上安裝一鍵式呼叫鈴,再聯合輸液多組登記表的改良方法,以提高患者靜脈輸液服務質量的滿意度和護士工作效率,降低護士工作強度和節省人力經濟成本,經臨床實踐2年多后,效果顯著,報道如下。 1 資料與方法 1.1 一般資料:大連醫科大學附屬第一醫院是三級甲等醫院,金普院區急診輸液室共有30個輸液椅位和3個平車位,參與研究共有7名在崗護士,年齡25~50(39.3±9.3)歲;工作年限11~32(20.12±10.62)年;主任護師1名;主管護師5名,護師1名。根據中聯醫院信息系統統計2019年的年輸液量為46137人次,其中更換第二瓶起輸液袋共20506袋。2019年4月便利抽樣法選取急診輸液室患者303例為研究對象。按計算機數字隨機分組法分為實驗組和對照組,各觀察1周時間。實驗組:2019年4月1日-7日(第一周),采用輸液椅扶手上安裝一鍵式呼叫鈴聯合“輸液多組登記表”的護理方法共163例患者;對照組:2019年4月15日-22日(第三周),采用傳統方法患者自主呼喊護士的護理方法共140例患者。納入標準:①每天8:00~12:00為觀察時間。②具有2組以上輸液袋且連續輸液1~7 d的輸液患者。③年齡:≥18周歲的成年患者。④知情同意的患者。排除標準:①不同意參與調研的患者。②連續輸液大于7天以上的輸液患者。③僅有1組輸液袋的輸液患者。兩組患者年齡、性別、診斷等一般情況比較,差異均無統計學意義(均P>0.05)),具有可比性,見表1。

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