Abstract:

Objective　To observe the intervention effect of risk management based on test critical values on nursing safety in nephrology. Methods　The convenience sampling method was adopted to randomly select 200 nephrology patients from Wuxi Second People's Hospital from January 2017 to December 2020, who were given routine nephrology nursing. In order to further improve the nursing safety degree, the hospital began to carry out the risk management based on the test critical values since July 2019. The general data questionnaire was used to collect the gender, age, and disease type in nephrology patients. The general data of patients admitted to the hospital were compared between from January 2017 to June 2019 (before implementation) and from July 2019 to December 2020 (after implementation), the incidences of no treatment within 10 min, unqualified specimen collection, delayed disease tracking, and effective complaints on nursing staff before and after implementation were compared, and the processing success rate, the successful treatment time, the time of issuing diagnosis and treatment tasks, the time of reporting the critical values were compared. Independent sample t test and χ² test were used to determine the differences between groups. Results　In the pre-implementation group, there were 57 males and 45 females, aged (52.53±5.61) years; in the post-implementation group, there were 53 males and 45 females, aged (52.39±5.79) years. The incidences of no treatment within 10 min, unqualified specimen collection, delayed disease tracking, and effective complaints in the post-implementation group were significantly lower than those in the pre-implementation group [3.06% (3/98) vs. 17.65% (18/98), 2.04% (2/98) vs. 14.71% (15/98), 1.02% (1/98) vs. 9.80% (10/98), 2.04% (2/98) vs. 12.75% (13/98)] (all P<0.05). The processing success rate of the post-implementation group was higher than that of the pre-implementation group [92.97% (172/185) vs. 82.01% (155/189)] (χ²=10.225, P=0.001); the successful treatment time [(1.75±0.43) d vs. (2.35±0.56) d] and the completion time of reporting the critical value events [(25.15±3.12) min vs. (40.31±10.25) min] in the post-implementation group were significantly lower than those in the pre-implementation group (both P<0.001). Conclusions　Risk management based on test critical values is the management way to train the critical values in nursing staff in nephrology. It can improve the timeliness of nursing staff's critical value processing, improve the qualified rate of specimen collection, track the condition more timely, reduce the nursing complaints, and shorten the treatment time.

Key words: Test, Critical values, Nephrology, Nursing

摘要： 目的　观察基于检验危急值的风险管理用于肾内科护理安全的干预效果。方法　采用便利抽样法随机抽取无锡市第二人民医院2017年1月至2020年12月就诊的肾内科患者200例，应用常规肾内科护理，为进一步提升护理安全程度，于2019年7月开始进行基于检验危急值的风险管理。利用一般资料调查表收集肾内科患者的性别、年龄、疾病类型，比较2017年1月至2019年6月（实施前）、2019年7月至2020年12月（实施后）两个时间段入院患者的一般资料差异，实施前后护理人员的10 min内未处理、标本采集不合格、病情追踪不及时、有效投诉事件发生率及处理成功率、成功救治时间、下达诊疗任务时间、上报危急值完成时间，并通过独立样本t检验、χ²检验确定组间差异。结果　实施前组男57例，女45例，年龄（52.53±5.61）岁；实施后组男53例，女45例，年龄（52.39±5.79）岁。实施后组患者10 min内未处理[3.06%（3/98）比17.65%（18/98）]、标本采集不合格[2.04%（2/98）比14.71%（15/98）]、病情追踪不及时[1.02%（1/98）比9.80%（10/98）]、有效投诉事件发生率[2.04%（2/98）比12.75%（13/98）]均显著低于实施前组（均P<0.05）。实施后组患者处理成功率高于实施前组[92.97%（172/185）比82.01%（155/189）]（χ²=10.225，P=0.001）；实施后组成功救治时间[（1.75±0.43）d比（2.35±0.56）d]、上报危急值事件完成时间[（25.15±3.12）min比（40.31±10.25）min]均显著低于实施前组（均P<0.001）。结论　基于检验危急值的风险管理是对肾内科护理人员的检验危急值加以培训的管理方式，可提升护理人员的危急值处理时效性，提升标本采集合格率，病情追踪更为及时，降低护理投诉事件，且能够下调救治时间，优化危急值事件处理流程，有利于救治成功率的提升。

关键词: 检验, 危急值, 肾内科, 护理