骨科手术患者术中护理风险评估指标体系的构建研究

发布时间：2018-10-25 08:48

【摘要】：目的:(1)回顾性调查某三甲综合医院手术室护士四年上报的所有骨科手术术中护理不良事件,为骨科手术患者术中护理风险评估指标体系的初步构建提供依据。(2)对5所三级甲等医院手术室护士对骨科术中护理风险的认知、影响因素现况进行临床调研,为指标体系的进一步完善构建提供依据。(3)基于以上两方面的调查结合相关国内外文献及指南、专家咨询构建骨科手术患者术中护理风险评估指标体系。方法:本研究以患者十大安全目标为指导,结合文献分析法、问卷调查法,德尔菲专家咨询法、层次分析法确定指标及权重,构建骨科手术患者术中护理风险评估指标体系。结果:专家积极性为100%,权威程度系数经计算为0.83,经过2轮专家咨询,形成10个一级指标,35个二级指标,82个三级指标的骨科手术患者术中护理风险评估指标体系。该评估指标体系的一级指标涵盖了骨科手术患者术中可能遇到的10项护理风险,分别为坠床、错误手术、输血用药缺陷、液体渗出及静脉炎、压疮、体位性神经损伤、标本管理缺陷、电外科设备灼伤、手术物品遗留体内、术中低体温。该评估指标体系对护士识别、评估、管理骨科手术患者术中护理风险有重要意义。结论:在文献分析法、现况调查法的基础上结合德尔菲专家咨询法及层次分析法研制的骨科手术患者术中护理风险评估指标体系覆盖的术中护理风险类型较全面,有助于护士在手术过程中对护理风险进行识别、干预管理,提高骨科手术患者安全。
[Abstract]:Objective: (1) to investigate retrospectively all the adverse events in orthopedic surgery reported by nurses in operating room of a general hospital for four years. To provide the basis for the preliminary construction of the risk assessment index system for orthopedic surgery patients. (2) to investigate the cognition of nursing risk and the influencing factors of nurses in 5 operating rooms of Grade 3A Hospital. For the further improvement of the index system to provide the basis. (3) based on the above two aspects of the investigation combined with relevant domestic and foreign literature and guidelines, experts to build orthopaedic surgery patients intraoperative nursing risk assessment index system. Methods: under the guidance of the ten safety targets of patients, combined with literature analysis, questionnaire survey, Delphi expert consultation, AHP to determine the index and weight, to establish the risk assessment index system of orthopedic surgery patients during operation. Results: the enthusiasm of experts was 100, the coefficient of authority was 0.83. after two rounds of expert consultation, a risk assessment index system for orthopedic patients during operation was established, which included 10 first-grade indexes, 35 second-class indexes and 82 third-order indexes. The first-degree indicators of the evaluation system cover 10 nursing risks that may be encountered during orthopedic surgery, including falling bed, false surgery, defective blood transfusion, fluid exudation and phlebitis, pressure sore, postural nerve injury, etc. Specimen management defects, electrosurgical equipment burns, surgical objects left in vivo, intraoperative hypothermia. The evaluation index system is very important for nurses to identify, evaluate and manage the risk of orthopaedic surgery. Conclusion: the type of intraoperative nursing risk of orthopaedic patients with orthopaedic surgery covered by the index system of intraoperative nursing risk assessment, which is based on literature analysis, current situation investigation and Delphi expert consultation method and analytic hierarchy process, is more comprehensive. It is helpful for nurses to identify nursing risks, intervene in management and improve the safety of orthopedic patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6

【参考文献】