目的 基于危机管理4R理论构建护理安全质量管理体系,应用于临床护理安全质量管理,并对效果进行实用性分析,为临床护理安全质量管理提供新思路.方法 以危机缩减、危机预备、危机反应、危机恢复四个环节为节点,建立健全护理安全质量管理架构,围绕“患者十大安全目标”制定护理安全质量标准;采用多种方式进行安全培训,以图表式流程图指引启动应急流程;以现代管理方法引导组织及系统恢复.结果 构建护理安全质量管理体系后(2015年),护理安全质量评分、护理人员应急能力、规避纠纷能力显著高于2013年,护理不良事件发生率显著低于2013年(P＜0.05,P＜0.01).结论 基于危机管理4R理论构建护理安全质量管理体系并应用于临床,有助于促进护理安全质量管理.%Objective To construct the nursing safety and quality management system based on 4R crisis management theory,then apply it in clinical nursing safety and quality management and analyze its application effect,and to provide new ideas for clinical nursing safety and quality management.Methods We firstly established the nursing safety and quality management framework taking the four links of crisis reduction,crisis readiness,crisis response and crisis recovery as nodes,and formulated nursing safety and quality control standards focusing on "ten safety targets of patients";then carried out safety training using many methods,guided and launched the emergency process with flow chart;finally,guided organizations and system recovery with modern management methods.Results After the construction of the nursing safety and quality management system (2015),the evaluation of nursing safety and quality,the emergency care ability of nursing staff and their ability to avoid dispute were significantly higher than those in 2013,and the incidence rate of nursing adverse events was significantly lower than that in 2013 (P＜0.05,P＜0.01).Conclusion Construction and clinical application of the nursing safety and quality management system based on 4R crisis management theory could help to promote the quality of nursing safety management.
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