老年消化道出血患者的安全因素分析及防范

目的分析老年消化道出血患者住院期间的不安全因素，加强护理安全管理，保证护理质量，提高患者满意率，最大限度地防止护理不良事件的发生。方法对2009年我科收治的223例老年消化道出血患者进行安全因素分析，同时制定相应防范措施，并与2008年201例同类患者进行患者住院天数、再次出血发生率、基础护理合格率、患者满意率及安全问题发生率等护理指标比较。结果影响患者安全的生理因素中，“患有慢性疾病的老年人”比例最高占85．4％，影响安全的社会心理因素中“经济条件差”比例最高占54％，影响安全的环境因素及护理人员因素中“认为护士与患者交流沟通少，解释及指导不够”的比例最高占67％。2009年的患者平均住院天数下降，与2008年比较差异有统计学意义[（9．3±0．35）d比（11．5±0．50）d，t=52．887，P〈0.01]；基础护理合格率、患者满意率有显著提高，再次出血发生率及安全问题发生率显著下降，与2008年相比差异均有统计学意义（P〈0.05）。结论认真分析安全问题，找出影响患者安全的不利因素，采取有效的护理安全管理对策，可取得较好的护理效果。

Safety factor analysis and precaution of elderly alimentary tract hemorrhage patients

Objective To analyze unsafely factors of elderly alimentary tract hemorrhage patients,strengthen nursing safety, assure nursing quality, improve patients' satisfaction and avoid adverse events happen to our bestMethods 223 elderly alimentary tract hemorrhage patients were collected from January to December in 2009, and safety factors, corresponding precaution have been made meanwhile.Days in hospital, recurrence of bleeding and passing rate of basic nursing and satisfaction rate of patients and incident of safety problems were compared with those 201 peering patients collected in 2008.Results Of all the physical factors, "suffering chronic disease in elderly patients" is most and accounts for 85.4%.Of all the psychological factors, "low economical status" is most and accounts for 54%. "Less communication between nurses and patients and inadequate instruction" is most (67%) of environmental and nurse staff factors.Average days in hospital were reduced in 2009 than in 2008 [(9.3 ±0.35)d vs(11.5 ±0.50)d, t =52.887, P ＜0.01].Passing rate,satisfaction rate were improved and bleeding recurrence rate were decreased, compared with those in 2008 (P ＜0.05).Conclusions It will gain better nursing efficacy through analyzing security issue carefully, finding out the disadvantage factor influencing patients' security and adopting effectve nursing safety control strategy.