我院监护仪报警疲劳的多因素Logistic回归分析及改进对策

目的分析本院监护仪误报警情况以及医护人员报警疲劳的主要原因,并进行针对性的改进。方法选择上海市嘉定区安亭医院急诊科、综合ICU、CCU的护士63例作为研究对象。分析监护仪1周内不同类型的报警情况。采用报警疲劳量表调查护士对监护仪报警产生疲劳的程度并将护士分为疲劳组和未疲劳组。采用多因素Logistic回归分析影响护士对监护仪报警产生疲劳的独立影响因素。结果我院30台监护仪共记录报警8421次,其中错误报警5399次(64.1%),正确报警3022次(35.9%),正确报警中90.6%为无意义报警。疲劳组(n=41)护士工作年限高于未疲劳组(n=22),差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:“认为病情不会恶化”(P<0.001)、“监护仪设置有问题,但不懂如何设置”(P<0.001)以及“正在忙其他工作”(P=0.003)对护士产生报警疲劳感存在显著影响。结论设备科应当针对医护人员报警疲劳的主要原因建立起完善的报警管理体系,强化医护人员报警安全意识,减少错误报警次数。

Multi-Factor Logistic Regression Analysis and Improvement Countermeasures for Alarm Fatigue of Monitors in Our Hospital

Objective To analyze the main causes of false alarms in the hospital monitors and the alarm fatigue of medical staff,and to make targeted improvements.Methods A total of 63 nurses from the emergency department,ICU and CCU of Shanghai Jiading District Anting Hospital were recruited as subjects.Different types of alarms from monitors within 1 week were analyzed.The alarm fatigue scale was used to investigate the degree of fatigue of the nurses on the monitor alarm and the nurses were divided into fatigue group and unfatigued group according to the results.Multivariate logistic regression analysis was used to analyze the independent influencing factors affecting the alarm fatigue of nurses.Results A total of 8421 alarms were recorded in 30 monitors in our hospital,including 5,399 false alarms(64.1%)and 3022 correct alarms(35.9%).However,90.6%of correct alarms were meaningless alarms.The working life of the fatigue group(n=41)was higher than that of the unfatigued group(n=22),and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that“The patient's condition will not deteriorate”(P<0.001),“There is a problem with the settings of the monitor,but I don't know how to modify it”(P<0.001)and“I am busy with other work”(P=0.003)were independent influencing factors affecting the nurse's sense of alarm fatigue.Conclusion The medical equipment department should establish a perfect alarm management system for the main reasons of medical staff's alarm fatigue,strengthen the awareness of medical staff alarms,and reduce the number of false alarms.