医疗失效模式与效应分析在围手术期住院患者检查流程中的应用

目的探讨应用医疗失效模式与效应分析理论优化围手术期住院患者检查流程的效果。方法采用工作分解结构模式修订围手术期住院患者检查流程,应用医疗失效模式与效应分析对该流程进行失效风险评估和原因分析,制订质量改进方案,并对改进前后各项指标进行比较。结果实施围手术期住院患者检查管理持续质量改进后,检查流程落实的规范率、患者的满意度及护士检查相关知识掌握率均显著提高(P0.01或P0.05)。结论应用医疗失效模式和效应分析制订围手术期住院患者检查持续质量改进方案,有利于规范检查流程。     

医疗失效模式与效应分析在降低病人陪检风险中的应用

[目的]探讨医疗失效模式在降低病人陪检风险中的应用效果。[方法]运用医疗失效模式与效应分析对病人陪检过程进行管理,查找隐患,改进措施,提高病人安全性。[结果]运用医疗失效模式与效应分析后不良事件、安全隐患发生率下降;检查及时率和病人满意度提高。[结论]运用医疗失效模式与效应分析有助于优化病人陪检流程,保证病人安全。     

品管圈在构建智慧医疗医学影像信息化服务流程中的应用

目的观察品管圈在智慧医疗提升医学影像信息化服务流程构建中的应用。方法以2018年8月至2019年4月在北京大学深圳医院医学影像科接受检查的660例患者为研究对象,建立医学影像科信息平台和“品管圈”管理,通过品管圈活动步骤,评估品管圈活动前后医学影像科检查患者的服务模式和各项指标。结果患者应用品管圈前检查服务模式为预约→开单→缴费→检查→取结果→会诊→手术,应用品管圈后检查服务模式为患者诊间预约→网上缴费→检查→云胶片→远程会诊→急诊绿色通道→交流手术;应用品管圈后患者取结果等候时间、登记员整理胶片时间、二次补打胶片率、CT预约检查患者排队次数、卒中绿色通路影像检查时间显著低于应用品管圈前,差异有统计学意义(均P<0.05)。结论在智慧医疗提升医学影像信息化服务流程构建中应用品管圈活动,可简化工作流程,节约人力、物力成本,同时远程医疗诊断可节约患者的就诊时间和经济成本。     

医疗失效模式与效应分析在降低病人陪检风险中的应用

[目的]探讨医疗失效模式在降低病人陪检风险中的应用效果.[方法]运用医疗失效模式与效应分析对病人陪检过程进行管理,查找隐患,改进措施,提高病人安全性.[结果]运用医疗失效模式与效应分析后不良事件、安全隐患发生率下降;检查及时率和病人满意度提高.[结论]运用医疗失效模式与效应分析有助于优化病人陪检流程,保证病人安全.     

医疗失效模式与效应分析在造影剂外渗风险管理中的应用

目的探讨医疗失效模式与效应分析在造影剂外渗风险管理中的应用效果。方法应用医疗失效模式与效应分析理论,建立统一规范的高压自动注射造影剂流程,找出高风险的关键环节,并进行量化分析,制订解决方案。结果护士选择穿刺工具和套管潜行长度明显改善（P〈0．01）,外渗率下降（P〈0．05）。结论应用医疗失效模式及效应分析理论管理,能显著降低造影剂外渗发生率,保证患者安全。     

医疗失效模式与效应分析在降低胃管滑脱率中的应用

目的探讨医疗失效模式与效应分析在降低胃管滑脱率中的应用效果。方法根据医疗失效模式与效应分析工作流程,确定主题,组建团队,制订流程图,分析各流程步骤中的潜在失效模式、失效原因及失效结果,进行严重度、可能性、危机值分析,根据分析结果制订相应改进措施并落实。结果胃管脱出率由3.52%下降至0.45%(P<0.05)。结论应用医疗失效模式与效应分析有助于细化胃管护理流程,降低胃管脱出率。     

移动医疗在护理领域的应用进展

综述移动医疗的应用概况、实施现状、护理人员对移动医疗照护模式的接纳现状及影响因素,以期为更好地在国内开展移动医疗护理服务提供参考。其中移动医疗照护模式的实施现状包括移动医疗照护院内应用和院外应用,内容涉及护理管理、健康宣教、疾病延续护理和健康行为促进。护理人员接纳移动医疗照护模式的影响因素包括护理人员因素和移动医疗技术/设备因素等。     

运用PDCA循环法规范医疗废弃物的管理

目的规范医疗废弃物的管理,防止其成为社会环境的污染源。方法应用PDCA循环法对医疗废弃物的来源及护理人员进行评估,通过建立健全管理监控制度,规范操作流程,严格分类、标识、终末管理,把医疗废弃物管理纳入护理管理质量检查项目。结果护士的环境意识、法律意识、自我保护意识提高,针刺伤发生率明显下降(P<0.01),控制了医院感染源,医院感染发生率明显下降(P<0.01)。结论通过应用PDCA循环法对医疗废弃物实施无害化处理,可以有效预防和控制医院感染,减少对社会环境的污染。     

医疗失效模式与效应分析在基层医院综合病区输液安全管理中的应用

目的:探索医疗失效模式与效应分析(HFMEA)在基层医院综合病房静脉输液安全管理中的应用,以提高病人用药安全性。方法:利用HFMEA模式评估我院综合病房静脉输液流程,对存在或潜在的安全隐患进行分析,整合出前瞻性的改进措施。结果:通过对综合病房静脉输液流程分析,发现有6个失效模式需要加强改善,在应用HFMEA模式对综合病房静脉输液各个关键流程加强安全管理后,输液不良事件的发生率较前明显下降(P<0.05)。结论:运用HFMEA对综合病房静脉输液各环节中存在或潜在的安全隐患分析,采取预见性的安全措施干预,取得明显的效果。     

医疗失效模式与效应分析在ICU护理安全管理中的应用现状

介绍了失效模式与效应分析（FMEA）的起源、内涵、步骤、工具及医疗失效模式与效应分析（HFMEA）的概念,对国内外护理管理者采用HFMEA降低重症监护病房（ICU）病人的非计划性拔管率、给药风险以及院内感染率等高危流程的有效应用进行了综述,分析了该模式在 ICU 护理安全管理应用中的优势和局限性。     

加强医院护理风险管理的必要性

为探讨医院护理风险管理 ,阐述了对护理风险的认识、护理风险管理的必要性、护理风险管理的程序和内容。实施护理风险管理对提高护理人员的风险防御能力 ,减少护理差错及纠纷 ,提升护理品质有着积极的作用     

基层医院医疗废弃物管理的现状分析与对策

目前,部分基层医院医疗废弃物管理存在监督管理组织不健全、认识不足、设施简陋、处置存在误区等问题。以《医疗废物管理条例》为准则,提出宣传和监管并举;加大医疗废弃物处理设施的建设投入;完善设施、规范处置流程、严格废弃物分类和环节管理等对策与建议。     

病区护士长的风险意识与风险管理

通过分析病区工作中存在的主要护理风险及其可能的原因,如何建立相应的防范措施来探讨病区护士长的风险意识和病区风险管理的实施。以期提高护理人员在医院风险管理中的作用,保证护理安全,提高护理服务质量。     

Examining the relationship between risk assessment and risk management in mental health

Thorough risk assessment helps in developing risk management plans that minimize risks that can impede mental health patients' recovery. Department of Health policy states that risk assessments and risk management plans should be inextricably linked. This paper examines their content and linkage within one Trust. Four inpatient wards for working age adults (18-65 years) in a large mental health Trust in England were included in the study. Completed risk assessment forms, for all patients in each inpatient ward were examined (n= 43), followed by an examination of notes for the same patients. Semi-structured interviews took place with ward nurses (n= 17). Findings show much variability in the amount and detail of risk information collected by nurses, which may be distributed in several places. Gaps in the risk assessment and risk management process are evident, and a disassociation between risk information and risk management plans is often present. Risk information should have a single location so that it can be easily found and updated. Overall, a more integrated approach to risk assessment and management is required, to help patients receive timely and appropriate interventions that can reduce risks such as suicide or harm to others.     

Risk assessment and management for providers of community-based rehabilitation to people with acquired brain injury: Health professionals' perspectives

Purpose.?This study aimed to explore health professionals' perspectives regarding the presence, assessment and management of risks when providing community-based rehabilitation (CBR) to clients with acquired brain injury (ABI).

Method.?A qualitative approach using semi-structured interviews of health professionals working in CBR.

Results.?The main themes were: (1) risk assessment in CBR settings is an informal, unstructured, complex, multi-phase and cyclical process extending over a period of time; (2) structured and standardised risk assessments were not considered ideal for use in CBR services catering for people with ABI; (3) CBR services face numerous challenges in providing effective risk assessment and management; (4) the risks encountered by health professionals in CBR settings are not always predictable or preventable; and (5) CBR risk management focuses on implementing a range of practical strategies.

Conclusions.?A flexible risk assessment process supported by a range of practical risk management strategies to minimise and manage potential risks is advocated by health professionals working in CBR services for people with ABI. There is a need for more research into the effectiveness of current risk assessment and management strategies for CBR services.     

Deconstructing risk assessment and management in mental health nursing

RATIONALE: Risk assessment and management have a taken a central position in the delivery of contemporary mental health services. However, these concepts are generally taken-for-granted as necessary and unavoidable aspects of mental health nursing practice. This deconstructive analysis explores some of the assumptions and values that underpin these concepts. AIMS: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. DESIGN: This paper takes a deconstructive approach to the exploration of the historical, clinical, cultural, political and economic context of the concept of risk and its assessment and management. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. FINDINGS: The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organization. CONCLUSION: The mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.     

护理风险管理新进展

本文从护士、患者、药物、医院卫生学、护理文书、告知行为、护息沟通等方面分析了产生护理风险的相关因素,并提出相应的管理对策.包括:加强风险教育,提高护士或护理管理人员对风险的识别和评估能力;提高护理技术水平和职业道德素养;健全风险管理机制;加强护患沟通,建立良好的护患关系;积极处理风险事件等,有效地推进科学化、系统化、制度化的护理质量管理工作,为患者提供更安全、有序、优质的护理服务.     

老年医院预防患者跌倒管理流程建立与应用

目的:通过建立与实施预防患者跌倒管理流程,探讨控制老年住院患者跌倒发生率的有效方法。方法:对病区住院患者实施预防跌倒管理流程,主要内容包括入院评估、签署"预防跌倒告知单"、高危警示标识的应用、针对高危因素采取有效预防措施、强化对患者及家属进行健康教育及不良住院环境的改善等。结果:实施预防患者跌倒管理流程可降低跌倒发生率,有助于建立合作性护患关系,提高患者的依从性,减少了医疗纠纷的发生。     

护理风险的前瞻性管理和全程动态管理在急诊科病人抢救中的应用

目的 探讨护理风险的前瞻性管理和全程动态管理在急诊科的应用效果.方法 通过识别和分析急诊科在抢救病人中存在和潜在的护理风险,对护理风险实施前瞻性管理和全程动态管理.结果 急诊科护理质量和病人对急诊科工作满意度明显提高,病人投诉及护理差错发生率大为下降.结论 护理风险的前瞻性管理,是降低急诊科护理风险的根本保障;护理风险的全程动态管理,是降低急诊科护理风险的重要手段.     

我科实施护理风险管理的方法与效果

目的降低护理风险，保障孕产妇的住院安全。方法成立护理风险管理小组，按照风险管理程序，实施护理风险鉴别、风险评估、风险控制、风险监督。结果孕产妇对护理的满意度及护理质量提高，护理投诉事件降低。结论对产科病区实施风险管理，可以有效提高护理质量。