危机管理模式在急诊科护理管理中应用的有效性探究

目的 观察危机管理模式在急诊科护理管理的应用有效性,以提高急诊护理管理质量。 方法 选择嘉兴市第二医院急诊科2014年1月—2015年1月收治的123例急诊患者和8名护士作为对照组，采用常规急诊护理管理模式；同时选择2015年1月—2016年1月的123例急诊患者和8名护士作为干预组，采用急诊危机管理模式。统计2组患者急诊病情救治情况、危机事件发生次数、患者满意度和2组护士护理管理情况。 结果 干预组患者急诊疾病救治有效率、危机事件发生率和患者满意度分别是98.37%、3.25%和97.56%，对照组为88.62%、28.46%、83.74%，差异有统计学意义(χ2=9.63、29.28、13.86；P＜0.05)；干预组护士护理管理中护患沟通、工作能力、护理文书、危机意识4个方面的评分分别为(18.5±1.0)分、(19.2±0.3)分、(19.8±0.2)分和(19.0±0.5)分，高于对照组的(11.2±1.5)分、(13.4±1.4)分、(15.5±1.1)分和(8.7±1.3)分，2组比较差异具有统计学意义(t=11.45、11.46、10.88、20.92；P＜0.01)。 结论 危机管理模式的实施降低急诊科危机事件的发生率,提高了急诊疾病救治率和患者满意度，护理管理方面也有了明显的提高，总体效果优于常规急诊护理管理模式，值得临床推广。 

Effectiveness of crisis management mode in nursing management in emergency department

Objective To observe the effectiveness of crisis management mode in the nursing management in emergency department,and improve the quality of emergency nursing management. Methods Total 123 emergent patients from January,2014 to January,2015 were assigned into the control group,that received the routine emergency nursing from 8 nurses; while other 123 emergent patients from January,2015 to January,2016 were assigned into the intervention group,that received the nursing management based on crisis management mode. The illness treatment,number of crisis event,patient satisfaction and nursing management in the two groups were compared. Results The efficiency of emergency treatment,incidence of crisis event and patient satisfaction in the intervention group were 98. 37%,3. 25% and 97. 56%,respectively,and in the control group were 88. 62%,28. 46% and 83. 74%,respectively,the differences were significant(χ2=9. 63,29. 28,13. 86,P < 0. 05). The scores for the nurse-patient communication,operational capability,nursing documents and crisis consciousness in the intervention group were(18. 5 ±1. 0) points,(19. 2 ±0. 3) points,(19. 8 ±0. 2) points and(19. 0 ±0. 5) points,respectively,and in the control group were(11. 2 ±1. 5) points,(13. 4 ±1. 4) points,(15. 5 ±1. 1) points and(8. 7 ±1. 3) points,respectively,the difference were significant(t=11. 45,11. 46,10. 88,20. 92,P <0. 01). Conclusion The nursing care intervention on the bases of crisis management can reduce the incidence of the emergency crisis,raise efficiency of emergency treatment and improve the patient satisfaction. The overall effect is better than the conventional emergency nursing management model,thus worth of further promotion in clinical practice.