收稿日期: 2023-06-04
网络出版日期: 2024-05-16
Analysis of risk factors for nursing interruption events during the surgical counts
目的 调查与分析手术物品清点环节护理中断事件的现状及危险因素，为提出针对性的防范措施提供参考。方法 通过便利抽样法，选取2022年6月—10月山西省某三级甲等综合医院的手术进行观察，采用自行编制的手术物品清点环节护理中断事件调查表进行数据收集，分析手术物品清点环节护理中断事件的危险因素。结果 最终观察了385台手术，其中244台（63.4%）的手术物品清点环节发生护理中断事件。Logistic回归分析显示，外科医生数量、手术时间、多外科联合手术、急诊手术、巡回护士工作年限和器械护士学历是手术物品清点环节发生护理中断事件的危险因素。结论 手术物品清点环节受到多种危险因素的影响，早期识别并评估这些因素有助于早期干预护理中断事件，保证患者安全。
郭栋 , 付秀荣 , 李恒 . 手术物品清点环节护理中断事件的危险因素分析[J]. 中华护理教育, 2024 , 21(5) : 574 -579 . DOI: 10.3761/j.issn.1672-9234.2024.05.011
Objective To investigate and analyze the current situation and risk factors of nursing interruptions during the process of surgical counts，and provide empirical evidence for targeted preventive measures. Methods Based on convenient sampling method，operations performed in a Class III general hospital in Shanxi Province from June 2022 to October 2022 were selected as the observation objects. The self-developed questionnaire of Nursing Interruption Events in the Counting of Surgical Items was used in data collection，and the risk factors for nursing interruptions during surgical counting sessions were analyzed. Results A total of 385 operations were eventually included，in which 244（63.4%） had nursing interruptions during the inventory of counts. Logistic regression analysis showed that the number of surgeons，surgery duration，surgeries of multi-surgical combination，emergency surgery，experience of circulating nurses，and education of scrub nurse were the independent risk factors for nursing interruptions during the inventory of counts. Conclusion The process of counting surgical items is influenced by various risk factors. Early identification and evaluation of these indicators is helpful in reducing nursing interruption events and maintain patient safety.
| [1] | 龚文龙, 周秋萍. 手术室手术物品清点管理的现状分析与对策[J]. 中医药管理杂志, 2019, 27(22):53-54. |
| [1] | Gong WL, Zhou QP. Analysis of the current situation and countermeasures of inventory management of surgical items in operating room[J]. J Tradit Chin Med Manag, 2019, 27(22):53-54. |
| [2] | 董文平, 丁万红, 徐建芳. 医疗失效及效应分析模式在手术室护理安全管理中的应用[J]. 护理研究, 2016, 30(1):102-105. |
| [3] | G?ras C, Olin K, Unbeck M, et al. Tasks,multitasking and interruptions among the surgical team in an operating room:a prospective observational study[J]. BMJ Open, 2019, 9(5):e026410. |
| [4] | 刘佳微. 重症监护室护理中断事件现况分析及干预策略在交接班中的应用[D]. 太原: 山西医科大学, 2020. |
| [5] | 谢建飞, 刘佳, 刘立芳, 等. 护理中断事件管理的实践与成效[J]. 中华护理杂志, 2016, 51(8):951-955. |
| [5] | Xie JF, Liu J, Liu LF, et al. Practice and effectiveness of management in nursing interruptions[J]. Chin J Nurs, 2016, 51(8):951-955. |
| [6] | 陆晶, 丁四清, 谢建飞, 等. 护理中断事件管理的研究进展[J]. 中华护理杂志, 2018, 53(5):617-621. |
| [6] | Lu J, Ding SQ, Xie JF, et al. Research progress on nursing interruptions management[J]. Chin J Nurs, 2018, 53(5):617-621. |
| [7] | 刘佳微, 张文光. 重症监护室护理中断事件的研究现状与对策[J]. 护理研究, 2020, 34(3):473-476. |
| [8] | 徐苗苗, 付秀荣, 张娜, 等. 老年结肠镜检查患者肠道准备失败风险评分模型的构建及验证[J]. 中华护理杂志, 2022, 57(11):1337-1344. |
| [8] | Xu MM, Fu XR, Zhang N, et al. Development and validation of a risk score model for inadequate bowel preparation for colonoscopy in elderly patients[J]. Chin J Nurs, 2022, 57(11):1337-1344. |
| [9] | Bretonnier M, Michinov E, Morandi X, et al. Interruptions in surgery:a comprehensive review[J]. J Surg Res, 2020,247:190-196. |
| [10] | Sevdalis N, Healey AN, Vincent CA. Distracting communica-tions in the operating theatre[J]. J Eval Clin Pract, 2007, 13(3):390-394. |
| [11] | Catchpole K, Perkins C, Bresee C, et al. Safety,efficiency and learning curves in robotic surgery:a human factors analysis[J]. Surg Endosc, 2016, 30(9):3749-3761. |
| [12] | Kalisch BJ, Aebersold M. Interruptions and multitasking in nursing care[J]. Jt Comm J Qual Patient Saf, 2010, 36(3):126-132. |
| [13] | Koh RYI, Yang X, Yin SQ, et al. Measuring attention patterns and expertise of scrub nurses in the operating theatre in relation to reducing errors in surgical counts[J]. Proc Hum Factors Ergon Soc Annu Meet, 2009, 53(11):669-673. |
| [14] | Rhéaume A, Mullen J. The impact of long work hours and shift work on cognitive errors in nurses[J]. J Nurs Manag, 2018, 26(1):26-32. |
| [15] | Min AR, Hong HC, Son S, et al. Sleep,fatigue and alertness during working hours among rotating-shift nurses in Korea:an observational study[J]. J Nurs Manag, 2021, 29(8):2647-2657. |
| [16] | 刘丽, 刘伟, 董建英, 等. 护理不良事件网络直报系统在儿科护理管理中的应用[J]. 中国数字医学, 2016, 11(4):4-7. |
| [16] | Liu L, Liu W, Dong JY, et al. Application of nursing adverse events direct network report system in pediatric nursing management[J]. China Digit Med, 2016, 11(4):4-7. |
| [17] | Morley RL, Elliott L, Rees J, et al. Scoping review of mode of anaesthesia in emergency surgery[J]. Br J Surg, 2020, 107(2):e17-e25. |
| [18] | 韩小云, 张成欢, 吴程程. 手术室护理中断事件现状及护士感受的调查分析[J]. 护士进修杂志, 2022, 37(24):2278-2282. |
| [19] | 付莉霞. 优化急救护理流程对重症颅脑创伤急诊手术患者救治效果的影响观察[J]. 基层医学论坛, 2022, 26(17):118-120. |
| [19] | Fu LX. Observation on the influence of optimizing emergency nursing process on the treatment effect of patients with severe craniocerebral trauma undergoing emergency surgery[J]. Med Forum, 2022, 26(17):118-120. |
| [20] | Ma JH, Bai Y, Xie DS, et al. Factors influencing the interrup-tion of nursing document writing in the intensive care unit:a cross-sectional survey[J]. J Multidiscip Healthc, 2023,16:419-427. |
| [21] | 郑惠芳, 谢丽萍, 董卫红, 等. 护理给药错误的调查分析及应对策略[J]. 解放军护理杂志, 2012, 29(24):59-62. |
| [22] | Liu G, Yang MH, Zhu SW, et al. Effect of orthogeriatric co-management on geriatric hip fractures in China[J]. Orthop Surg, 2022, 14(4):671-677. |
| [23] | Lau TW, Fang C, Leung F. The effectiveness of a multidisci-plinary hip fracture care model in improving the clinical outcome and the average cost of manpower[J]. Osteoporos Int, 2017, 28(3):791-798. |
| [24] | S?rensen EE, Brahe L. Interruptions in clinical nursing prac-tice[J]. J Clin Nurs, 2014, 23(9/10):1274-1282. |
/
| 〈 |
|
〉 |