安全文化研究及其对我国护理的启示

“安全”是人的基本需要之一，保证患者安全是广大医护人员的重要职责，也是衡量医疗护理质量的重要标志之一。然而，近年来随着《医疗事故处理条例》的出台以及公民法律意识的不断增强，医院所面临的医疗风险日益加大。因此，如何提高医护人员的安全意识，加强医疗护理安全的前瞻性管理，减少和杜绝护理缺陷造成的纠纷和差错，确保患者安全，已成为当前国内外学者关注的热点。[第一段]     

呼吸内科危重患者的护理安全管理

护理安全足指在实施护理的全过程中，患者在不发生法律和法定的规章制度允许范围以外的心理机体结构或功能上的损害、障碍、缺陷或死亡。护理安全管理是护理管理的重点，是决定患者医疗安全的匝要因素。危重患者病情复杂多变，对护理工作有较高要求，因此工作中应强化质量意识，规范服务行为，确保患者安全，减少医疗纠纷的发生。现将本科从2006～2008年加强危重患者护理安全管理，取得的经验总结报道如下。     

缺陷共享模式在护理安全管理中的实践与应用

目的：探讨缺陷共享模式在护理安全管理中的应用与效果。方法：通过设立无障碍缺陷报告系统和多元化的缺陷分析方法对护理缺陷及护理安全隐患进行预防和分析。结果：实施前后护理缺陷的发生率比较,差异具有统计学意义（P〈0.05）。结论：缺陷共享模式有助于预防和降低护理缺陷,保障患者安全,促进护理安全文化的建设。     

杜邦安全管理理论对护理安全管理的启示

护理安全是病人在接受护理的全过程中，不发生法律和法定的规章制度允许范围以外的心理、机体结构或功能上的损害、障碍、缺陷或死亡。护理安全是患者的基本需要和保障，同时也是衡量医院管理水平的重要标志。完善的护理安全管理体系可为     

安全文化研究及其对我国护理的启示

"安全"是人的基本需要之一,保证患者安全是广大医护人员的重要职责,也是衡量医疗护理质量的重要标志之一。然而,近年来随着《医疗事故处理条例》的出台以及公民法律意识的不断增强,医院所面临的医疗风险日益加大。因此,如何提高医护人员的安全意识,加强医疗护理安全的前瞻性管理,减少和杜绝护理缺陷造成的     

老年住院患者安全隐患的探讨与对策

目的 探讨老年住院患者的安全隐患，并提出相应的安全措施。方法 针对2168例老年患者的住院现况及可能发生的意外，创造安全的住院环境，提供周到的护理服务。结果 进一步保障了老年人的住院安全，促进了患者疾病的恢复和生活质量的提高。结论 做好老年患者的安全护理是护理工作的重要内容之一，更是医疗安全的重要保障。     

对护理人员进行患者安全培训的应用与效果

目的探讨对护理人员进行患者安全培训的方法及效果。方法成立培训小组,构建患者安全文化氛围,制订不良事件上报制度及安全管理制度,对典型案例进行全院护理安全大讨论,开展安全护理技能培训及加强新护士岗前培训。结果实行患者安全护理培训后4年护士在口服给药、静脉给药、静脉采血、输血、患者身份辨识等安全操作评分较培训前4年均显著提高(P<0.05或P<0.01);建立护理不良事件报告系统前后4年,护理不良事件发生例次、护士对不良事件报告制度的知晓率、护理缺陷例次较实施前有所增加(P<0.05或P<0.01),护理差错例次较前降低(P<0.05)。结论加强护理人员的患者安全培训,有利于提高患者满意度,规范护士的安全护理行为,降低护理差错的发生,保障患者安全,提升护理服务质量。     

分析护理安全影响因素 强化安全防范策略

安全是人的基本需求，护理安全是患者的基本权利。随着社会经济发展、科技进步，人们的卫生保健需求与日俱增，对医疗护理安全提出了更高的要求。由于医疗护理活动日趋复杂化，各种影响因素不断增加，使患者在医院接受诊疗和护理的同时也面临着一定的风险。如何在实施护理的全过程中保障护理安全，不发生法律和法定的规章制度允许范围以外的心理、机体结构或功能上的损害、障碍、缺陷或死亡，是每一个护理人员的责任。通过分析影响护理安全的因素，查找隐患，有针对性的予以规避、防范，防患于未然，为患者提供安全放心的就医环境，提高患者满意度。     

门诊输液室护理缺陷原因分析与防范措施

护理缺陷是指在护理活动中出现技术、服务、管理等方面的失误。护理安全是保证护理质量的前提，是为患者提供安全、放心、满意的优质服务的基本保证。但目前门诊输液室护理工作还存在着许多安全隐患，我们对门诊输液室护理缺陷的发生进行分析，提出防范措施。现报告如下。     

护理安全的影响因素与管理对策

护理安全是指在实施护理的全过程中，患者不发生法律和法定的规章制度允许范嗣以外的心理、机体结构或功能上的损害、障碍、缺陷或死亡。护理安全是患者的基本需要，是医院生存的根本。安全管理是护理管理的重点，也是护理质量的保证。自2005年以来，随着医院管理年活动的广泛深入开展，结合本院开展全院性的“质量安全教育活动”，通过充分认识影响护理安全的诸多因素，并有针对性的采取相应对策，有效的保证了护理质量。     

Simulation-based learning for patient safety: The development of the Tag Team Patient Safety Simulation methodology for nursing education

BackgroundSince the ground-breaking report ‘To Err is Human: Building a Safer Health Care System’ was published nearly two decades ago, patient safety has become an international healthcare priority. Universities are charged with the responsibility of preparing the future nursing workforce to practise in accordance with relevant patient safety standards. Consequently, simulation-based learning is increasingly used for developing the technical and non-technical skills graduates require to provide safe patient care.AimTag Team Patient Safety Simulation is a pragmatic group-based approach that enhances nursing students’ knowledge and skills in the provision of safe patient care. The aim of this paper is to describe the Tag Team Patient Safety Simulation methodology and illustrate its key features with reference to a medication safety scenario.MethodsInformed by the National Safety and Quality Health Service Standards and the Patient Safety Competency Framework for Nursing Students, Tag Team Patient Safety Simulation methodology actively engage large numbers of nursing students in critical conversations around every day clinical encounters which can compromise patient safety.ConclusionTag Team Patient Safety Simulation is a novel simulation methodology that enhances nursing students’ skills and knowledge, fosters critical conversations, and has the potential to enhance students’ resilience and capacity to speak up for safe patient care.     

Patient safety: a shared responsibility

Patient safety is an essential and vital component of quality nursing care. However, the nation's health care system is prone to errors, and can be detrimental to safe patient care, as a result of basic systems flaws. A variety of stakeholders (society in general; patients; individual nurses; nursing educators, administrators, and researchers; physicians; governments and legislative bodies; professional associations; and accrediting agencies) are responsible for ensuring that patient care is safely delivered and that no harm occurs to patients. The responsibility of these stakeholders in addressing patient safety in the context of a nursing shortage is discussed, along with specific actions they have taken, and can continue to take, to promote safe care.     

Patient safety in an English pre-registration nursing curriculum

This study explored patient safety in an English pre-registration nursing curriculum. The need to improve patient safety has been recognised as a key priority, both nationally and internationally. Education has a crucial role in developing the knowledge, skills and attitudes that promote patient safety. However, evidence about how patient safety is addressed in healthcare professional curricula and how organisations develop safe practitioners is limited.An organisational case study identified factors affecting patient safety educational provision. Content analysis revealed what aspects of patient safety featured in the formal pre-registration nursing curriculum. Interviews were conducted with students, lecturers and key education stakeholders from various levels of the educational organisation, to explore their perceptions of patient safety and its location in the curriculum and practice.Patient safety was not explicit in the formal curriculum, but was included in teaching. Students reported gaining most knowledge and experience from clinical practice. The organisational culture of both education and practice was characterised as defensive and closed, and as having an individual versus a systems approach. Findings suggest the need for clarification of the concept of patient safety, as well as revision of curricula and teaching, learning and assessment strategies in order to address patient safety explicitly.     

151例无陪护住院老年患者围手术期的护理管理

对医院外科系统9个科室需要手术的151例无陪护住院老年患者实施了围手术期无陪护护理管理.包括护理安全评估、护理照顾分级、设定无陪护患者围手术期临床路经、建立护理小组、进行护理质量控制等.解决了无陪护住院老年患者围手术期的安全与舒适问题,提高了患者及其家属的满意度.     

Introducing Nursing Students to an Environmental Safety Assessment Through Simulation

In response to the Institute of Medicine report criticizing health care professionals' competence in providing safe patient care, health care educators were challenged to transform their nursing programs. One powerful tool in developing competent nurses, without endangering patients, is simulation. This article discusses advantages and disadvantages of using simulation as a teaching strategy and describes how to teach environmental safety concepts to beginning nursing students, through a simulated patient room using an environmental safety assessment.     

责任制整体护理模式对患者安全保障体系的作用

目的：探讨责任制整体护理模式在临床护理工作中对患者安全保障体系所产生的作用。方法：通过＂督导式＂的管理模式来指导护理工作;每名护理人员参加主任医师查房,能主次分明、重点突出地了解患者的病情。对于特殊病例、疑难病例通过会议的形式组织学习以提高护理人员的专业知识。还能明确各岗位护士的职责,护理服务内涵、服务目标和工作标准。结果：可提供一个安静、整洁、安全、有序的病房环境;又能很好落实患者的基础护理、安全管理制度,提高了护理质量、服务满意度。结论：责任制整体护理模式既可持续提高护理质量,又能很好的为患者的安全提供保障。     

Report cards: relevance for nursing and patient care safety

The emergence of health care report cards in the North American environment is outlined. While it is evident that substantial activity has emerged, the majority of these initiatives excluded nursing, or use a broad indicator for nursing that may not provide meaningful representations of the quality of nursing care provided in the system and the relevance of this care to patient care safety. Given that nurses are the primary care provider in health care settings, this represents a significant gap in health care report cards. The pioneering work of the American Nurses Association (ANA) Nursing Report Card in the development and validation of report card indicators for nursing is discussed. Challenges related to data availability and data quality are identified. Potential opportunities for linking nursing practice outcomes to patient care quality and patient safety through a report card process are outlined.     

实习护生患者安全胜任力的现状调查及其影响因素分析*

目的：调查实习护生患者安全胜任力的现状,并分析其影响因素,为开展针对实习护生的患者安全教育和医疗风险培训提供依据。方法：便利选取天津市教学医院308名实习护生为研究对象,采用“患者安全胜任力护理人员自评表”进行横断面调查。结果： 实习护生患者安全胜任力自评得分为（3.70±0.37）分。态度因素、系统因素、知识因素和技能因素4个维度得分分别为（4.22±0.49）分、（3.94±0.51）分、（3.44±0.54）分和（3.41±0.54）分。学历和是否学过患者安全相关内容是实习护生患者安全胜任力的主要影响因素（P<0.05）。结论：实习护生患者安全胜任力总得分处于中等水平。知识因素和技能因素得分偏低。医学院校应为提高护生的患者安全认知开设患者安全教育课程,临床教学医院应通过建立非惩罚性不良事件上报系统并加强患者安全相关教育以提高实习护生的患者安全胜任力。