基于患者导向服务的老年慢性病患者输液护理服务模型构建

目的 探讨"基于患者导向服务的老年慢性病患者输液护理服务模型"对保障输液安全的效果.方法 自行设计"老年慢性病患者输液护理服务需求问卷",内容包括环境、告知、技术、观察、生活协助、娱乐等6个一级条目和28个二级条目.采取面对面问答式,专人负责调查问卷信息采集和填写.构建输液护理模型,强化患者需求度较高的护理服务环节和流程.以医院内科片区为单位,改进前(2016年1月)为对照组,改进后6个月(2016年7月)为观察组,每组200例,调查出院前的满意度、心理状况评价(孤独感、抑郁),以及输液不良事件发生率.结果 一级条目中最期望提供技术、告知、观察等服务.二级条目,需求平均分值较高的分别是熟练的穿刺操作技术、告知药物作用和不良反应、观察针头脱出、睡眠休息、观察药物反应、输液期间及时巡视询问和处理不适、有预防输液时跌倒的措施等.改进前患者满意度为91.88%,改进后98.72%.观察组患者的孤独感、抑郁减轻(P<0.05);观察组跌倒、药物渗漏、药物不良反应、非计划拔管、输液管道堵塞等不良事件发生率均下降,差异有统计学意义(P<0.05).结论 "基于患者导向服务的老年慢性病患者输液护理服务模型",以患者接触点和服务过程为线索,通过完善的护理管理和护理支撑来实现优质护理服务,提供患者感受和主观体验所需求的护理服务内容和模式,促进老年人配合和参与治疗,提高输液过程的舒适度,保障输液安全.

Construction of transfusion nursing model for elderly chronic disease patients based on patient oriented service

Objective To investigate the effect on infusion safety of nursing model base on the patient-centered medical service.Methods Self design questionnaire on elderly patients in infusion process of nursing services, including 6 first class entries, which included environment, inform, technology, observation, life assistance, and entertainment, and 28 second class entries, were constructed.Intensive care services and processes to strengthen patients′ needs were carried out.Pre discharge satisfaction, psychological status (loneliness, depression), and the incidence of transfusion adverse events were compared between before improvement (January 2016, control group) and 6 months after the improvement (July 2016, experimental group).Results The informed, technical and observation aspects were most expected in the first class entries.The second entries, demanding skilled puncture technique, information of the drug name and role, observation of needle drop, sleep, rest, drug response, periodic inspection and etc.The patient satisfactions before and after improvement were 91.88% and 98.72%, respectively.The patients in the experimental group suffered significantly lower loneliness and depression (P<0.05).The falls, drug leakage, adverse drug reaction, unplanned extubation and pipeline blockage rats were significantly lower in experimental group (P<0.05).Conclusion Applying the patient-centered medical service to elderly patients with non-transfusion oriented service concept promotes cooperation and participation in treatment, improves the infusion process comfort, and ensures the safety of transfusion.