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

发布时间：2019-04-30 07:42

【摘要】：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(P0.05);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(P0.05)。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。
[Abstract]:Objective to explore the effect of "patient-oriented service-based infusion nursing service model for elderly patients with chronic diseases" to ensure the safety of infusion. Methods A self-designed questionnaire on the needs of infusion nursing service for elderly patients with chronic diseases was designed. The contents included environment, notification, technology, observation, life assistance, entertainment and other six first-level items and 28 second-level items. Adopt face-to-face question-and-answer mode, the person is responsible for collecting and filling out the questionnaire information. To construct the nursing model of transfusion and strengthen the nursing service link and flow of patients with high demand. A total of 200 patients in each group were selected as control group before improvement (January 2016) and 6 months after improvement (July 2016). Satisfaction and psychological status assessment (loneliness, depression) were investigated before discharge, according to the department of internal medicine of the hospital as unit, before improvement (January 2016) as control group, and 6 months after improvement (July 2016) as observation group. And the incidence of adverse events in infusion. Results first-level entries most expect to provide services such as technology, notification, observation, etc. Second-level items, the higher the average score of demand are skilled puncture operation techniques, inform the role of drugs and adverse reactions, observe needle prolapse, sleep rest, observe drug reactions, timely inspection during infusion to inquire and deal with discomfort, There are measures to prevent falls during infusion, etc. Patients' satisfaction was 91.88% before improvement and 98.72% after improvement. The incidence of adverse events, such as falling down, drug leakage, adverse drug reactions, unplanned extubation and clogging of infusion pipes, were all decreased in the observation group (P0.05). Conclusion "patient-oriented service-based infusion nursing service model for elderly patients with chronic diseases", taking patient contact point and service process as clues, can achieve high-quality nursing service through perfect nursing management and nursing support. To provide the content and mode of nursing services required by patients' feelings and subjective experiences, to promote the elderly to cooperate and participate in the treatment, to improve the comfort of the infusion process, and to ensure the safety of infusion.
【作者单位】：南方医科大学珠江医院临床护理教研室;云南省第三人民医院疼痛科;南方医科大学珠江医院门诊部;
【基金】：广东省科技计划项目(编号:2014A020212208)
【分类号】：R47

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