实施护理质量风险基金管理制度的效果分析

目的 探讨实施护理质量风险基金制度的效果。方法 对住院部302名护理人员实行风险基金制度,观察1年,对实施前(2000年)与实施后(2001年)护理工作中不良事件的发生率进行比较。结果 实施风险基金制度管理后,患者不良事件发生率与实施前比较有显著性差异(P<0.01)。结论 实施护理质量风险基金制度,加强护理人员工作责任心.减少患者不良事件发生,提高护理质量。     

风险管理在临床护理质量管理中的运用

护理部将医院风险管理的理念运用于护理质量管理 ,建立风险管理的组织架构 ,对风险事件进行明确的定义和分类 ,改进风险呈报系统 ,并开展风险评估和预警。管理者的观念转变了 ,受到了护士的欢迎 ,提高了管理质量     

手术室风险管理

介绍了风险及风险管理的定义、风险发生的原因、分类、研究现状及防范措施.提出对于手术室风险管理预防比处理更重要.预防风险发生的重点是建立风险管理制度及防范措施,提高法律意识及风险防范意识,及时控制及消除安全隐患因素,以便科学地预防风险,全面提高护理质量.     

加强护理风险管理 促进护理质量提升

为加强医院护理人员的质量意识及安全意识,提高为患者服务的水平和抗风险能力,护理部在强化护理质量管理的同时,对护理工作中可能遇到的各种风险隐患进行了分析与评估,制定和完善了突发公共卫生事件紧急预案与护理工作有关的紧急风险预案20余项、护理质量管理关键流程、护理缺陷管理措施等.通过加强护理风险管理,强化了护理人员的风险管理意识及质量意识,同时由于加强了与患者的沟通,护理工作得到了患者及家属的理解和配合,密切了护患关系,促进了护理质量的提升.     

Risk Perception and Cannabis Use in a Sample of Young Adults

Aim: To examine dimensions of cannabis risk perception among users and non‐users.

Setting: University campus.

Participants: Two hundred and thirty‐seven university students aged between 17 and 24 years.

Measurement: Measures included the frequency of past and present cannabis use, and perceptions of the level of overall risk of various categories of use. Cannabis users were asked to rate the risk of harming themselves at their current level of use. Fifteen dimensions of cannabis risk perception were also assessed.

Findings: Perceptions of risk varied across problem domains. Approximately 60% of respondents considered physical addiction to be a great risk for those using at least 2–3 times per week compared with 25% for legal problems. Adverse acute effects (particularly anxiety) were not considered to be a great risk by most of the sample.

Conclusions: Risk perception varies considerably across problem domains, and users of cannabis do not necessarily perceive low personal risk. This is particularly relevant for the design of intervention programmes. It is recommended that referral information be readily available at universities for the proportion of students who feel personally vulnerable to risks associated with cannabis.     

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.     

A concept analysis of forensic risk

Forensic risk is a term used in relation to many forms of clinical practice, such as assessment, intervention and management. Rarely is the term defined in the literature and as a concept it is multifaceted. Concept analysis is a method for exploring and evaluating the meaning of words. It gives precise definitions, both theoretical and operational, for use in theory, clinical practice and research. A concept analysis provides a logical basis for defining terms through providing defining attributes, case examples (model, contrary, borderline, related), antecedents and consequences and the implications for nursing. Concept analysis helps us to refine and define a concept that derives from practice, research or theory. This paper will use the strategy of concept analysis to find a working definition for the concept of forensic risk. In conclusion, the historical background and literature are reviewed using concept analysis to bring the term into focus and to define it more clearly. Forensic risk is found to derive both from forensic practice and from risk theory. A proposed definition of forensic risk is given.     

护理人员在营养风险筛查中的作用

营养风险筛查是临床营养支持治疗的基础。护理人员在营养风险筛查中应扮演重要角色。应建立护士主导的多学科营养支持小组,实现住院患者营养筛查与干预的常规化。对存在营养风险的患者,通过营养支持治疗可改善患者临床结局和成本效果比。     

老年病房实施风险管理的做法与体会

目的探讨老年病房的护理风险管理方法,减少风险事件发生。方法针对老年病人易发生跌倒、坠床等意外事件,制订防范措施。加强培训,提高护士风险防范意识,尤其加强对低年资护士的管理,建立规章制度,加强健康教育。结果实施风险管理后,护理意外、护理差错和静脉穿刺失败率显著降低（P〈0．01）。结论针对老年病房常见的护理风险,制订针对性预防措施,可以减少风险事件的发生。     

我国煤矿业风险管理现状的循证评价--医疗风险系列研究之二

目的循证评价我国煤矿业风险及管理现状，为同属高风险行业的医疗行业风险控制提供参考。 方法计算机检索EI（1969～2005）、SDOS（1995～2005）、维普全文数据（1989～2005）、万方数据库（会议论文：1997～2005；学位论文：1977～2005）、CNKI数据库（1994～2005）、MSHA（msha．gov）及相关官方网站。收集我国矿业安全现状、应急救援、风险管理及预警的文献。语种限制为英文和中文。结果共纳入19篇文献，其中官方文献9篇，研究性文献4篇，专家评论6篇。近年我国煤矿业安全状况有所改善，矿难呈下降趋势，但远较美国高。占全国煤矿90％的小煤矿安全问题突出。我国煤矿业应急救援及预警体系还不完善。结论我国医疗行业应吸取我国矿难频发的教训，积极关注占我国医疗机构68．24％的诊所的医疗服务质量，对各级医务人员开展多层面、多形式、多内容培训，提高其风险防范意识和法律意识，并建立员工主动上报小差错制度。     

护理风险管理指标体系的构建研究

目的构建一套护理风险管理指标体系,提高管理者的风险防范能力。方法采用文献评阅法、Delphi法确定指标及权重。结果探索构建了一套包含3个一级指标、10个二级指标、39个三级指标的护理风险管理指标体系。结论该指标体系对护理风险管理工作有指导意义,有利于保障患者安全、提高护理质量。     

我院实施风险管理的方法与效果

目的探讨风险管理的方法与效果。方法在新院运转初期运用系统风险管理方法进行护理安全管理，比较新、老两院同期护理缺陷及差错的发生率。结果新老两院护理缺陷及差错发生率差异无统计学意义（P〉0．05）。结论实施风险管理，及早识别并杜绝各类风险隐患，是护理安全管理的有效手段。     

我国成人呼吸机相关性肺炎发生危险因素研究的文献计量学分析

[目的]分析我国成人呼吸机相关性肺炎(VAP)危险因素研究现状,为早期主动筛查监测VAP高风险人群、制定预防管理措施、进行科学防控提供理论依据。[方法]检索中国知网、万方数据库和维普数据库自建库起截至2018年12月发表的有关成人VAP危险因素的文献,采用文献计量法进行分析。[结果]共检索到218篇VAP发生危险因素文献,发表文献数量呈逐年上升趋势。其中有54篇(24.77%)获得基金资助,《中华医院感染学杂志》发文量占首位,达29篇(13.30%)。发表的文献质量总体相对较高,有55.96%的文献发表在核心期刊上,但尚需有效提高研究方法的科学严谨性,扩大研究的规模和范围。病人发生VAP的高危因素共计40项,主要包括病人一般情况、病情、生理生化指标、治疗措施因素4个方面。[结论]我国VAP高危因素研究日益增多,研究论文的数量和质量也取得了长足的进步,但研究质量和规模有待进一步提高。建议通过早期筛查与管理高危人群,积极治疗基础疾病,调节机体免疫力,规范诊疗护理行为,从而实现对VAP的主动监测、及时评估和降低潜在感染风险。充分利用信息化平台,实现VAP日常风险评估和前瞻性监测与预警,降低VAP发生率,改善病人预后。     

Y理论在护理风险管理中的应用

目的：探讨Y理论在护理风险管理中的应用。方法：应用Y理论,采用改变呈报表格、对风险事件当事人和科室给予保密、对呈报事件或填报潜在风险表格的护理人员发感谢信和感谢卡片等方法,营造呈报风险事件的安全氛围,激发护理人员呈报事件的责任感和成就感,提高风险事件呈报率和准确率。结果及结论：Y理论对促进员工的风险事件的呈报有独到作用,可在护理风险管理中应用。     

ICU危重症患者的护理风险及其管理对策

文章介绍了ICU危重症患者护理风险源(系统缺陷、护理人员、患者、社会环境)及高危因素(高危人群、高危时段、重点部位、重点环节),以及相应的风险管理对策,并对危重症患者风险管理规律的研究前景进行了展望。     

北京市社区护士职业风险感知现状调查与分析

目的 调查北京市社区护士感知的职业风险的现状,为科学制订防范社区护士职业风险策略提供依据.方法 采用便利抽样法,选取北京市99名社区护士作为研究对象,应用自制的社区护士职业风险评估问卷进行调查.结果 社区护士风险指数平均得分为(6.40±3.04)分;46项职业危害条目中,2项为3级风险,其余均为4级风险,其中3级风险...     

Evaluating the impact of an electronic application of the Dynamic Appraisal of Situational Aggression with an embedded Aggression Prevention Protocol on aggression and restrictive interventions on a forensic mental health unit

Risk assessment is a pre‐requisite for violence prevention in mental health settings. Extant research concerning risk assessment and nursing intervention is limited and has focused on the predictive validity of various risk assessment approaches and instruments, with few attempts to elucidate and test interventions that might prevent aggression, and reduce reliance on coercive interventions. The integration of risk assessment and violence prevention strategies has been neglected. The aim of this feasibility study was to test a novel Aggression Prevention Protocol designed to prioritize the instigation of less restrictive interventions on an acute forensic mental health unit for female patients. A prospective quasi‐experimental study was designed to test an Aggression Prevention Protocol, linked to an electronic application of the Dynamic Appraisal of Situational Aggression (DASA). Following introduction of the DASA and Aggression Prevention Protocol, there were reductions in verbal aggression, administration of Pro Re Nata medication, the rate of seclusion, and physical and mechanical restraint. There was also an increase in documented nursing interventions. Overall, these results support further testing of the electronic application of the DASA and the Aggression Prevention Protocol.     

2015年大理州宾川县重性精神病患病状况调查

目的：了解2015年大理州宾川县重性精神病的患病状况。方法由大理州精神病医院专家组对528例疑似精神病患者进行筛查，根据总体危险度指标评定患者的总体危险度，根据肇事肇祸危险度指标评定患者的肇事肇祸危险度，依据危险度评定结果对患者进行分级管理。结果本组528例疑似精神病患者中筛查前已确诊重性精神病40例(7.6%)，本次筛查确诊重性精神病290例(54.9%)，排除46例(8.7%)，未接受筛查152例(28.8%)。确诊重性精神病患者中总体危险度≥3级占27.3%，≥4级占7.3%；肇事肇祸危险度≥3级占17.3%，≥4级占4.9%；患者分级管理1级69.4%、2级19.4%、3级4.6%、4级6.7%。结论宾川县重性精神病患者总体危险度及肇事肇祸危险度高，政府应从多方面入手改善这一状况。     

和谐管理理论应用于医疗风险管理的启示

阐述了医疗风险管理的特点和目前我国医疗风险管理的现状,提出运用和谐管理理论的思想与风险管理相结合、利用双规则的互动耦合机制丰富医疗风险管理的思想,并论述了和谐管理理论对医疗风险管理的指导意义,为医疗风险管理的深入研究奠定了基础。