护理查对方法的改进及效果观察

目的观察护理查对方法改进后的“四查八对”制度在预防临床护理差错中的效果，并论证执行“四查八对”制度的可行性。方法（1）通过分析本院2009年上报护理部的护理差错及患者参与查对能力调查结果，依据患者十大安全目标要求，建立并执行“四查八对”制度，即在原“三查七对”的基础上增加一查一对，一查是增加患者或家属参与查；一对是增加药物质量和有效期的核对。观察实施“四查八对”制度前后护理差错发生情况。（2）采用自行设计的问卷分别对2009年和2010年的363例和392例住院患者进行了参与查对相关知识和护理安全满意度调查，并进行对比分析。结果（1）执行“四查八对”制度后，护理差错发生率由0．23‰降至0．13‰，差异有极显著性（X^2=7．89，P〈0．01）。（2）患者对参与查对相关知识知晓率由25．6％升高至75．3％，患者满意度由76．9％升高达98．5％，差异均有极显著性（X^2=81．6，P〈0．01；X^2=83．8，P〈0．01）。结论“四查八对”作为护理核心制度应用于临床，保障了护理安全措施的进一步落实，促进了护理健康教育水平的提高，进而提高了患者的满意度，较“三查七对”具有优越性、可行性，值得推广应用。

Effect observation on the nursing checking method improvement

Objective To observe the effect of the four out of eight on system after nursing checking method improvement in the prevention for clinical nursing errors, and demonstrate the implementation of the four out of eight on the feasibility of the system. Methods ①Through the analysis of this school in 2009 reporting the nursing department nursing errors and patient participation to check ability survey results, in accordance with ten safety objectives and requirements, the establishment and implementation of four eight system, in the o- riginal three out of seven on based on the increase in a pair, a check was increased patients or their families par ticipation in check; and drug quality and validity check were added. And we observed the implementation of the four out of eight on system before and after the occurrence of nursing errors. ②Using the self-designed questionnaire in 2009 and 2010 respectively, 363 cases and 392 cases of hospitalized patients were involved in the search for knowledge and the nursing safety satisfaction survey, and a comparative analysis was made. Results ①The implementation of four out of eight on system, nursing errors rate dropped from 0.23%0 to 0.13%o （ X^2=7. 89, P〈0.01）, the difference was statistically significant. @Patients participated in the relevant knowledge rate increased from 25.6% to 75.3% （ X^2=81.6, P〈0.01）; patients＇ satisfaction was increased from 76.9% up to 98.5% （ X^2=83.8, P〈0.01）, the difference was statistically significant. Conclusion Four out of eight on as applied to clinical nursing core system, can guarantee nursing safety measure be fulfilled further, promote the nursing health education level, and improve patients＇ satisfaction, a three out of seven on has the superiority and feasibility, it is worthy of popularization and application.