摘要
目的分析住院老年精神障碍患者发生不良事件的特点,为有针对性制定护理措施提供参考。方法回顾性分析某三级甲等精神卫生专科医院2014—2018年6月30日发生的不良事件,将≥60岁的老年精神障碍患者发生的不良事件与<60岁的非老年精神障碍患者发生的不良事件进行对比分析。结果2014-2018年6月30日共发生217起不良事件,其中111起跌倒坠床,75起意外事件,11起皮肤压疮,4起用药错误,1起管道滑脱。住院老年精神障碍患者不良事件发生率为1.18%,明显高于非老年精神障碍患者0.38%;老年患者发生不良事件的后果的严重程度为(2.71±1.14)。发生不良事件老年精神障碍患者与非老年精神障碍患者在年龄、疾病诊断、护理级别、入院时日常生活活动能力评分、住院时长、自我照顾能力方面比较差异均有统计学意义(P<0.05)。老年患者与非老年患者意外事件发生率比较,差异有统计学意义(x^2=10.694.P=0.030)。结论跌倒是发生概率较高的不良事件;其次精神科患者的不良事件有其特殊性,一方面是意外事件发生较多,而且情况较复杂,种类多样化。建议加强对信息上报为意外项目的管理,同时关注护理人员在日常生活活动能力评分和患者生活自理能力判断上标准的一致性,并进一步规范意外事件上报归类管理,以便分析总结,为提高医疗管理质量奠定坚实基础。
Objective To analyze the characteristics of adverse events among elderly inpatients with mental disorders so as to provide a basis for formulating targeted nursing intervention. Methods From 2014 to 30th June 2018, a retrospective analysis was used to analyze the adverse events at a Class Ⅲ Grade A mental health specialized hospital. We compared the adverse events between elderly (≥ 60 years old) patients with mental disorders and non-elderly (< 60 years old) inpatients without mental disorders. Results From 2014 to 30th June 2018, there were 217 adverse events, in which 111 fell or fell off bed, 75 were accidents, 11 were pressure ulcers, 4 medication errors and 1 were pipeline slippage. The incidence of adverse events among elderly inpatients with mental disorders was 1.18% higher than that (0.38%) among non-elderly in patients without mental disorders. Among elderly patients, the severity of adverse events was (2.71 ± 1.14). In the patients who had been through adverse events, there were statistical differences in age, disease diagnosis, nursing levels, scores of activities of daily living (ADLs) on admission, hospital stay and self-care ability between elderly and non-elderly inpatients with mental disorders(P < 0.05). There was statistical difference in the incidences of accidents between elderly and non-elderly patients ( x^2=10.694, P=0.030). Conclusions Falling is an adverse event with high incidence. It has special characteristics among patients in mental health department there there are many accidents, and the situation is complex with great varieties. The management of reported accidents should be improved. We should also pay attention to the consistency in the scores and judgment criteria of ADL among nurses, and make incident reporting system standardized so as to provide a firm basis for improving quality of medical management by analyzing and summarizing.
作者
李菲菲
费琤
张健一
Li Feifei;Fei Zheng;Zhang Jianyi(Department of Geriatrics, Beijing Huilongguan Hospital, Beijing 100096, China)
出处
《中华现代护理杂志》
2019年第13期1599-1604,共6页
Chinese Journal of Modern Nursing
基金
北京市医院管理局“青苗”计划专项经费资助(QML20172001).
