加强薄弱环节管理 提高老年患者护理质量

目的加强薄弱环节管理，提高老年患者护理服务质量。．方法查找老年患者护理管理的薄弱环节有重点时段（重大节假日，双休日、早中晚时间段，危重患者抢救、出入院患者周转高峰期，治疗护理工作量大、护士人数减少的时段）；重点患者（危重、长期卧床、行动不便、静脉输液、手术及留置各种管道等易发生安全问题的患者）；重点护士（基本功不够扎实、服务意识不够强的护理人员）；重点环节（指交接班、医嘱执行和查对、患者特殊用药及治疗护理操作等环节）。针对这些薄弱环节制定有效的管理措施：按照工作量和患者情况合理调配人力资源，实行弹性排班；在重点时段和重点环节增加查房次数，加大检查指导力度；组织对重点患者进行安全评估，加强护理安全管理；加强基础护理质量管理。结果2006年在危重患者数量增加、护理人员不增加的情况下，基础护理质量合格率、操作考试达标率、患者满意度均较上年同期提高；不安全事件的发生数量减少。结论加强薄弱环节管理，有利于减少护理风险，提高老年患者护理服务质量。

Enhancement of Circumstances Management for the Purpose of Improvement of Nursing Quality for the Elderly Patients

Objective To improve the nursing quality for the elderly patients by enhancing circumstances management. Methods The weak links, by investigation, were found to include critical time （major holidays, weekends, morning, noon and night time, rush hours for saving patients or patient＇s check-in and check-out, large work load but few nurses）, critical patients （the critical patients, those lying in bed for long time, those can not move or receiving venous transfusion or surgery or catheteration of all sort）, major nurs- es （those with poor skills and poor service sense） and critical links （shifts reporting, execution and check of medical orders, special medication, manipulation of treating and care）. Circumstances management was carried out pertinent to the weak links, the measures including flexible shifts based on reasonable allocation of human resources, additions of nursing rounding and enhancement of inspec- tion and instruction at critical time points, organization of safety assessment over critical patients, enhancement of basic nursing qua- lity. Results In 2006, in spite of increase of critical patients and the same number of nurses, qualification rates of basic nursing care, nursing report writing, examinations of nursing skills were increased, compared to the same time of last year. The number of medical incidents fell down and the satisfactory rate of patients were raised. Conclusion Use of circumstances management into nursing management of the elderly patients is good for reduction of nursing risks and increase of service quality for the elderly.