精细化管理在妇科病房护理安全管理中的应用

摘要

Objective To explore the applied effects of meticulous management on gynecological nursing care in gynecological department , and to offer some rationales and theoretical support for better hospital management .Methods The meticulous management was implemented for one year from September 2012 in two affiliated hospitals of Xi ’ an Jiaotong University .Before and after the meticulous management was carried out , patients and their family members were investigated with satisfaction degree questionnaires .Mistake incidence was evaluated , and nursing care quality was assessed .Satisfaction scores , incidence of mistake , and nursing care quality score were analyzed and compared before and after the implementation of meticulous management .Results After implementation of meticulous management , the satisfaction scores of patients and their family members were higher , and the difference was significant (χ2 =42.94,P<0.05).Also, incidence of mistake was significantly lower after the implementation of meticulous management (χ2 =4.44,P<0.05).After implementing meticulous management , the dimensions of nursing care quality , such as emergency management , head nurse management , document writing, disinfection, quality of different works in nursing , basic nursing,“three base” examination and awareness rate of health education were significantly higher (t value was 10.88, 14.65, 16.06, 35.53, 22.33, 22.20, 30.40 and 45.30, respectively, all P<0.05). Conclusion The meticulous management can improve the satisfaction degree of patients and their family numbers , reduce mistakes , and enhance nursing care quality .The meticulous management is worth to be applied and generalized to improve nursing care quality .%目的：探讨精细化管理在妇科护理安全管理中的应用及效果，为医院管理者提供理论支持。方法从2012年9月起对西安交通大学两家附属医院的妇科病房实行严格地精细化管理一年。2012年8月（精细化管理前）及2013年9月（精细化管理一年后）分别对妇科的患者及其家属进行满意度问卷调查，统计差错事故的发生率，评估护理质量并对精细化管理实施前后患者及其家属的满意度得分、差错事故的发生率及护理质量得分进行比较和分析。结果实施精细化管理后患者及其家属的满意度高于实施精细化管理前的满意度，差异具有统计学意义（χ2＝42．94，P＜0．05）；实施精细化管理后妇科病房差错事故发生率减少，与实施精细化管理前相比，差异具有统计学意义（χ2＝4．44，P＜0．05）；精细化管理实施后护理质量的急救品管理、护士长管理、文件书写、消毒隔离、各班工作质量、基础护理、“三基”考核和健康教育知晓率等各维度得分均高于精细化管理实施前的护理质量得分（t值分别为10．88、14．65、16．06、35．53、22．33、22．20、30．40和45．30，均P＜0．05）。结论精细化管理不但能提高患者及其家属的满意度，而且能降低差错事故的发生率，改善护理服务质量，保障妇科病人的护理安全，因此要大力提倡精细化护理管理，提高护理管理质量。