【摘要】：目的:(1)回顧性調(diào)查某三甲綜合醫(yī)院手術(shù)室護(hù)士四年上報(bào)的所有骨科手術(shù)術(shù)中護(hù)理不良事件,為骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)評(píng)估指標(biāo)體系的初步構(gòu)建提供依據(jù)。(2)對(duì)5所三級(jí)甲等醫(yī)院手術(shù)室護(hù)士對(duì)骨科術(shù)中護(hù)理風(fēng)險(xiǎn)的認(rèn)知、影響因素現(xiàn)況進(jìn)行臨床調(diào)研,為指標(biāo)體系的進(jìn)一步完善構(gòu)建提供依據(jù)。(3)基于以上兩方面的調(diào)查結(jié)合相關(guān)國(guó)內(nèi)外文獻(xiàn)及指南、專家咨詢構(gòu)建骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)評(píng)估指標(biāo)體系。方法:本研究以患者十大安全目標(biāo)為指導(dǎo),結(jié)合文獻(xiàn)分析法、問卷調(diào)查法,德爾菲專家咨詢法、層次分析法確定指標(biāo)及權(quán)重,構(gòu)建骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)評(píng)估指標(biāo)體系。結(jié)果:專家積極性為100%,權(quán)威程度系數(shù)經(jīng)計(jì)算為0.83,經(jīng)過2輪專家咨詢,形成10個(gè)一級(jí)指標(biāo),35個(gè)二級(jí)指標(biāo),82個(gè)三級(jí)指標(biāo)的骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)評(píng)估指標(biāo)體系。該評(píng)估指標(biāo)體系的一級(jí)指標(biāo)涵蓋了骨科手術(shù)患者術(shù)中可能遇到的10項(xiàng)護(hù)理風(fēng)險(xiǎn),分別為墜床、錯(cuò)誤手術(shù)、輸血用藥缺陷、液體滲出及靜脈炎、壓瘡、體位性神經(jīng)損傷、標(biāo)本管理缺陷、電外科設(shè)備灼傷、手術(shù)物品遺留體內(nèi)、術(shù)中低體溫。該評(píng)估指標(biāo)體系對(duì)護(hù)士識(shí)別、評(píng)估、管理骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)有重要意義。結(jié)論:在文獻(xiàn)分析法、現(xiàn)況調(diào)查法的基礎(chǔ)上結(jié)合德爾菲專家咨詢法及層次分析法研制的骨科手術(shù)患者術(shù)中護(hù)理風(fēng)險(xiǎn)評(píng)估指標(biāo)體系覆蓋的術(shù)中護(hù)理風(fēng)險(xiǎn)類型較全面,有助于護(hù)士在手術(shù)過程中對(duì)護(hù)理風(fēng)險(xiǎn)進(jìn)行識(shí)別、干預(yù)管理,提高骨科手術(shù)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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.6

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