53例护理纠纷原因分析及对策

目的总结2a来处理护理纠纷的经验，提出减少护理纠纷的策略及如何处理护理纠纷。方法回顾分析我院2003—2005年53例护理纠纷的处理过程。结果53例护理纠纷中，50例经过积极的调查、解释、书面回复等处理后院内解决；1例上诉法院（院方胜诉）；因护理过失行为与患方协商经济补偿2例。结论减少护理纠纷有赖于对纠纷原因的查找，及时堵塞漏洞；及时化解护理纠纷有赖于对护理纠纷的处理技巧和相关科室知情者的大力协助及密切配合。     

运用危机公关理论处理护理纠纷

运用公关危机理论 ,回顾性分析 1998～ 2 0 0 0年度我院处理的 18起护理纠纷 ,主要采取了紧急行动、积极处置、重塑形象、事后加强改进等措施 ,使护理纠纷得到及时、妥善的处理 ,最大限度地保障病人的权益及维护医院的形象 ,提示护理人员减少护理纠纷的根本是提高服务意识 ,加强责任心 ,不断提高护理技术水平。     

手术室护理纠纷的防范

目的探讨手术室护理纠纷的防范。方法 2008年4月至2009年10月对45例在手术室发生的护理纠纷,通过护士长和全体护士讨论,针对临床多例护理纠纷采取措施并制订工作计划。结果通过各种护理措施及时到位,使45例护理纠纷均得到及时解决,患者满意。结论有效的预防是减少护理纠纷发生的关键。     

产科静脉用药发生不良反应的护理观察与纠纷防范

目的：提高护理人员对发生药物不良反应的应对能力，减少纠纷的发生。方法：收集我院产科发生的28例药物不良反应的患者的资料，从一般资料、用药原因、药物种类、药物不良反应表现、不良反应的处理等五个方面进行分析，提出加强静脉用药滴数的观察；规范服务用语、细心观察；高度重视、及时抢救处理；当发生药物不良反应引发的纠纷时及时联系高职称的药师协助解决。结果：出现药物不良反应的28例患者均治愈出院，虽有4例引发纠纷，由于及时发现、处理得当，纠纷得以平息。结论：对产科静脉用药进行细致的护理观察和规范的服务用语，以及及时有效的处理，是保证护理安全和防范纠纷的手段。     

急诊护理存在纠纷原因分析与对策

目的:探讨急诊护理存在纠纷原因分析与对策.方法:分析并调查42例急诊患者护理纠纷原因,并制订应对措施.结果:42例急诊护理纠纷中,服务态度差14例,患者对护理人员护理技术不满意8例,分诊不准确6例,相关科室协调不当5例,定性为护理一般差错4例,护理文书书写不当3例,急救用物故障2例.结论:明确发生纠纷的相关因素,及时采取有效的预防措施,及时了解患者的心理问题,为其提供满意的护理,可有效避免和减少护理纠纷的发生.     

46例护患纠纷相关因素分析和防范对策

随着我国法律制度的不断健全和人们自我保护意识的增强以及对医疗保健的要求愈来愈高 ,医患或护患纠纷的发生率也日趋上升。我院于近年发生护患纠纷 46例。现就 46例护患纠纷的相关因素进行讨论 ,并提出相应的防范对策。1　对象和方法本组资料由我院在 1996～ 2 0 0 0年 5 a间医德医风纠察岗记录或医疗纠纷处理记录统计获取。2　结果从 46例护患纠纷分布的岗位及年龄组情况看 (见表 1) ,主要有以下 6项原因 :1服务态度生硬导致患者或家属不满 ;2责任心不强 ,护理工作不及时到位 ;3未能严格执行护理工作制度导致护理缺陷 ;4患者或家属对护理…     

细节护理管理的加强在妇产科护理中对风险及护患纠纷的影响

目的:分析细节护理管理的加强在妇产科护理中对风险及护患纠纷的影响作用。方法:研究选取了本院妇产科在2017年6月至2018年11月收治的110例患者作为研究对象,按照入院顺序进行分组,一组给予常规的护理管理,一组给予细节护理管理,分别作为对照组与干预组,比较两组患者的护理效果。结果:干预组护理风险发生率为5.45%(3例),护患纠纷发生率为3.64%(2例),各项数据低于对照组,数据差异有统计学意义(P<0.05,χ2=4.2744/3.9600);干预组患者的护理满意度为96.36%(53例),高于对照组的81.82%(45例),两组数据差异有统计学意义(P<0.05,χ2=5.9864)。结论:细节护理管理可有效减少妇产科护理风险和护患纠纷的发生率,并提高患者的护理满意度,临床应用价值高。     

护士、医生与临床药师合作处理静脉输液相关药患纠纷的实践

目的 使药患纠纷得到及时、妥善的处理.方法 设立药患纠纷处理专门小组,完善制度；快速反应,通知医生、临床药师协同处置；综合分析判断,各司其职分类处理；讨论总结,持续改进.结果 27例药患纠纷均得到了圆满解决,有效化解了矛盾.通过和药师密切合作处理药患纠纷,及时整改,2008～2012年的药患纠纷分别为15例、5例、4例、2例、1例,药患纠纷逐年减少.结论 护士、医生和临床药师合作处理药患纠纷,有利于药患纠纷的化解和处理,有利于药物不良反应的监测和上报.     

运用危机公关理论处理护理纠纷

运用公关危机理论，回顾性分析1998－2000年度我院处理的18起护理纠纷，主要采取了紧急行动，积极处置，重塑形象，事后加强改进等措施，使护理纠纷得到及时，妥善的处理，最大限度地保障病人的权益及维护医院的形象，提示护理人员减少护理纠纷的根本是提高服务意识，加强责任心，不断提高护理技术水平。     

预防和处理儿科临床护理纠纷的思考

目的：探讨预防和处理儿科护理纠纷的措施。方法：通过转变服务观念、提高专业技能、加强护患沟通、完善制度、规范管理等措施米提高护理服务质量，确保安全护理，从而最大限度地预防和避免护理纠纷；增强法律意识、避免矛盾激化、遵循规定程序、严格考核纪律，妥善及时地处理好已发生的护理纠纷。结果：预防和减少了儿科护理纠纷。结论：临床工作中根据儿科护理工作的特点，转变服务观念，提高服务曛量，满足患儿的安全护理需求，可有效预防和减少护理纠纷。     

儿科低年资护士护患纠纷认知情况及对策

目的调查儿科低年资护士护患纠纷的认知情况,并提出相应对策。方法采取授课、抽查、考核、发放问卷等方式,加深护士对护患沟通重要性及护患纠纷相关概念的认识,提高护理人员的道德水准、应对技巧及操作技能,和谐护患关系。结果通过学习,规范了护理行为,提高了患者满意度,减少了护理投诉。结论护理纠纷的减少依赖于对纠纷原因的查找和及时堵塞漏洞。     

已婚育龄妇女乳腺癌术后性生活质量的调查分析

目的评估育龄妇女乳腺癌术后性生活频率、性生活满意度等情况，为制订相应的护理措施提供依据。方法通过问卷调查与面谈的方式对60例，绝经前已婚乳腺癌术后6个月的患者，进行手术前后的性生活频率、性生活满意度的调查，比较手术前后患者性生活质量的差异。结果乳腺癌术后患者的性生活质量明显低于手术前。结论不同的文化背景、家庭条件、配偶的态度、性观念、性心理等因素可影响患者的性生活质量。     

加强分级护理制度管理方法的探讨

目的探讨加强分级护理制度管理的方法和效果。方法根据本院分级护理情况,从患者人院时对其进行科学的评估、住院时加强分级护理措施的细节管理、出院时进行护理质量的评价等方面加强分级护理制度的管理。结果患者满意度逐年提高,从2005年的81．0％上升到2008年的96．5％;医疗纠纷逐年下降,从2005年的8．1％下降到2008年的4．9％。结论加强分级护理制度管理,可有效提高临床护理工作质量,护理服务满意率和减少医疗护理纠纷的发生。     

基于 Benner 模式的护士岗位竞聘管理效果评价

目的：探讨优化护理人力资源管理的有效策略。方法按照护士岗位管理要求,基于Benner模式分层设置护理岗位,制定护士岗位竞聘条件,编写《护理岗位管理》手册,比较竞聘前后护士岗位管理质量情况。结果竞聘后N1、N2级护士的专业素养、危急重症护理技能、危急重症护理与监护、责任制整体护理、医院感染预防与控制、案例分析与情景演练等指标评分均高于竞聘前（ P＜0.01）,N3、N4级护士除危急重症护理技能评分外,其余几项评分均高于竞聘前,差异有统计学意义（ P＜0.01）。结论基于Benner模式的岗位竞聘管理有利于发展护士职业生涯规划,提升护士岗位胜任力,优化护理人力资源管理。     

护士长夜值班制改革的成效

目的:探讨综合医院在快速发展形势下如何确保护理质量与护理安全。方法:将护士长夜值班由每周2次、每次2人随机选科抽查改为每天19∶00～次日8∶00全部科室巡查。每人1 d,夜间住值班室。结果:培养了一支技术过硬、具备良好应急处置能力的护士长队伍,护理纠纷明显下降。结论:改进后的护士长夜值班制有利于培养护士长专业技能和协调能力,提升临床护理质量,保证护理安全。     

Impact of skill mix variations on patient outcomes following implementation of nursing hours per patient day staffing: a retrospective study

Aims. This article is a report of a study of the association between skill mix and 14 nursing‐sensitive outcomes following implementation of the nursing hours per patient day staffing method in Western Australian public hospitals in 2002, which determined nursing hours by ward category but not skill mix. Background. Findings from previous studies indicate that higher nurse staffing levels and a richer skill mix are associated with improved patient outcomes. Measuring skill mix at a hospital level for specific staffing methods and associated nursing‐sensitive patient outcomes are important in providing staffing for optimal patient care. Design. The research design for the larger study was retrospectively analysing patient and staffing administrative data from three adult tertiary hospitals in metropolitan Perth over 4 years. Methods. A subset of data was used to determine the impact of skill mix on nursing‐sensitive outcomes following implementation of the staffing method. All patient records (N = 103,330) and nurse staffing records (N = 73,770) from nursing hours per patient day wards from October 2002–June 2004 following implementation were included. Results. Increases in Registered Nurse hours were associated with important decreases in eight nursing‐sensitive outcomes at hospital level and increases in three nursing‐sensitive outcomes. The lowest skill mix saw the greatest reduction in nursing‐sensitive outcome rates. Conclusions. The skill mix of nurses providing care could impact patient outcomes and is an important consideration in strategies to improve nurse staffing. Levels of hospital nurse staffing and skill mix are important organizational characteristics when predicting patient outcomes.     

From the tower into the trenches: a nurse educator's reflections on the knowledge of experience

I have been in the tower for a long time. I have been teaching nursing for more than 20 years, and only now, after spending 6 months in the trenches as a staff nurse, have I begun to realize how far removed I had become from the real world of nursing. In this article, I will first discuss the experiences that motivated me to take a leave of absence from my teaching position in Canada for a staff nurse position in an acute care hospital in Florida. Then I will share my early reflections about what I learned as a staff nurse in Florida and how I interpreted this experience in the context of my own teaching practice and in the context of nursing education.     

Nurse-patient ratios: a systematic review on the effects of nurse staffing on patient, nurse employee, and hospital outcomes

OBJECTIVE: To determine whether the peer-reviewed literature supports specific, minimum nurse-patient ratios for acute care hospitals and whether nurse staffing is associated with patient, nurse employee, or hospital outcomes. BACKGROUND: Hospital care may be compromised by forces that have increased patient acuity, reduced the ratio of caregivers to patients, and lowered the level of training of these caregivers. METHODS: We systematically reviewed studies of the effects of nurse staffing on patient, nurse employee, and hospital outcomes published between 1980 and 2003 to determine whether they could guide the setting of minimum licensed nurse-patient ratios in acute care hospitals. RESULTS: Of 2897 titles and abstracts of interest, 490 articles were retrieved, and 43 met the inclusion criteria. Although all adjusted for case mix and skill mix, only one recent study addressed minimum nurse staffing ratios. Patient outcomes were limited to in-hospital, adverse events. Evidence suggests that richer nurse staffing is associated with lower failure-to-rescue rates, lower inpatient mortality rates, and shorter hospital stays. CONCLUSION: The literature offers no support for specific, minimum nurse-patient ratios for acute care hospitals, especially in the absence of adjustments for skill and patient mix, although total nursing hours and skill mix do appear to affect some important patient outcomes.     

规范输液不良反应的处理流程在护理风险管理中的应用

目的:通过规范输液不良反应的处理流程,降低护理风险,减少医院纠纷的发生。方法:自2005年5月1日开始,针对科内出现输液不良反应在处理方法上存在的风险问题,展开分析、讨论,从而制定和规范了输液不良反应的处理流程,经过1年的流程实施,再与规范前1年比较医疗纠纷和护理缺陷的发生情况。结果:规范后发生的医疗纠纷和护理缺陷由规范前的12起下降为2起,资料经χ2检验,差异有显著性(P<0.05)。结论:规范输液不良反应的处理流程,可提高护士的风险防范意识,指导和规范护士对输液不良反应的处理方法,减少纠纷和投诉。既保证了病人的权益,也保护了护士的利益。     

Home infusion therapy. First things first: the patient and the prevention of central catheter infections

During the past seventeen years, I've had the privilege of working as a home healthcare nurse in two rural counties in the Upper Peninsula of Michigan. In the early 1990s, it was rare that our agency received referrals for IV antibiotics, opiate infusions for pain management or for total parenteral infusion (TPN) to be administered at home. Most patients stayed in the hospital for infusion therapy. Today, as more healthcare treatments are being shifted from hospital to outpatient or home care settings, referrals for home infusion have become more common in our area as well as across the nation (Jarvis, 2001). I'll never forget my first patient whom I cared for with home infusion therapy for pain management. I learned a great deal from Sally, and to this day I always remember that I can make a real difference in patient outcomes when I keep--"First Things First": the patient and infection prevention--when caring for any of my patients.