基于目标管理法减少住院患者非计划性拔管长效机制的建立及效果评价

目的:建立基于目标管理法减少住院患者非计划性拔管（UE）的长效机制并评价其管理效果。方法:重庆医科大学附属第一医院自2015年开始实施目标管理法。遵循目标管理的基本原则及流程，通过成立领导和实施小组、确定控制目标、制订现场检查追踪内容和评价标准、加强全员培训、过程追踪并及时反馈等方法建立减少住院患者UE的长效机制，评价...

Establishment and effect evaluation of a long-term mechanism to reduce unplanned extubation of inpatients based on target management

Objective To establish a long-term mechanism to reduce unplanned extubation(UE)of inpatients based on target management and evaluate its management effect.Methods The target management was implemented in the First Affiliated Hospital of Chongqing Medical University since 2015.Following the basic principles and procedures of target management,the long-term mechanism to reduce UE of inpatients was established by building leadership and implementation teams,determining control targets,formulating on-site inspection and tracking content and evaluation standards,strengthening all-staff training,process tracking and timely feedback.We evaluated the incidence of UE,the replacement rate and the qualification rate of UE management in the ward from 2014 to 2018.Results From 2014 to 2018,there was no statistical difference in the incidence and replacement rate of UE(P<0.01).From 2015 to 2018,the incidences of UE in inpatients were 0.21%(141/72112)、0.08%(62/79284)、0.07%(52/69840)and 0.06%(41/71994)respectively,and the replacement rates of UE were 31.58%(48/152)、46.77%(29/62)、26.92%(14/52)and 26.83%(11/41),respectively.From 2015 to 2018,the qualification rate of UE management in the ward was 61.33%(92/150)、90.54%(134/148)、98.66%(147/149)and 98.37%(181/184)respectively.Conclusions The establishment of a long-term mechanism based on target management can continuously reduce the incidence and replacement rate of UE in hospitalized patients,improve the qualification rate of UE management in the ward and the correct management ability of nurses for UE,so as to achieve the goal of continuous quality improvement.