前馈控制在护理不良事件管理中的应用

目的 ：探讨前馈控制在护理不良事件管理中的应用效果。方法 ：运用前馈控制对护理不良事件进行管理,同时将护理隐患和不良事件进行分类。分析前馈控制应用前后,不良事件上报情况及其对患者产生的影响。结果 ：运用前馈控制对护理不良事件进行管理后,2012年全院上报护理隐患（A类事件）625例,2011年与2010年无A类事件上报记录;2012年上报护理不良事件（B类和C类事件）总例数为44例,较前增加（2011年36例、2010年39例）;2012年对患者产生影响的护理不良事件（C类事件）占比为25.00%,较前降低（2011年为52.78%、2010年为61.54%）。结论 ：运用前馈控制对护理不良事件进行管理,可鼓励护士对不良事件进行上报,降低不良事件对患者产生的影响。

Application of feedforward control in management of nursing adverse events

Objective： To study the effect of applying feedforward control theory in nursing adverse events management. Method： In 2012, we used feedforward control theory in the management of nursing adverse events, and classified nursing hidden trouble events（type A events） and adverse events based on the original nursing adverse events classification. Then, we analyzed the number of reported adverse events and their impact on patients. Results： After using feedforward control in the management of nursing adverse events, 625 nursing hidden trouble events（type A events） were reported in 2012. While there were no type A events reported before 2012. In 2012, there were 44 type B and type C nursing adverse events reported, which were more than 36 cases and 39 cases reported in 2011 and 2010 respectively. Type C events accounted for 25.00% of all nursing adverse events in 2012, which was lower compared to those of 52.78% in 2011 and 61.54% in 2010. Conclusion： Application of feedforward control in management of nursing adverse events can enhance nursing adverse events reporting rate and reduce their impact on patients.