Analysis And Countermeasures Of Nursing Adverse Events In A Three Grade Hospital Of Yunnan Province

ObjectiveTo explorethe main types of nursing adverse events,the main departments and personnel involved,the distribution of the time and so on,and comprehensively analyze their characteristics.The purpose of this study is to analyze the main causes of adverse events,to find the problem,and to put forward the corresponding countermeasures and suggestions in view of the main problems,in order to reduce medical risks and improve the quality of medical treatment,provide a reference to reduce the occurrence of medical accidents and medical disputes.To make known about the cognition,reporting and management of medical safety(adverse)events among nurses in the hospital.MethodsThis research adopts the method of literature survey retrieval at home and abroad databases such as CNKI,Wan fang database,PubMed database,a comprehensive system of inspection of the relevant literature of nursing adverse events,providing the varied theories and methods for this study.A retrospective review of medical safety(adverse)events reported by all nursing departments of the hospital in January 2015 to December 2016(2 years)was conducted.Establish Excel2007 database,using frequency,average,standard deviation,composition ratio to classify and describe the data.By means of literature review and expert consultation,a self-made questionnaire was developed.?the cognition of medical safety(adverse)events of nurses?.The collected data were analyzed by SPSS 17.0 statistical software.The T test and the analysis of variance were used to make a statistical difference between the cognitive score of the questionnaire and the basic information of the nursing staff.The correlation analysis was used to analyze the relationship between cognitive score of questionnaire and information of nursing staff.Multiple regression analysis was used to obtain the factors that affect the cognitive score of nursing adverse events.All the P values indicated two-tailed probability,and the test level was a=0.05.The nursing staff in our hospital,according to different age,years of different work,different departments,different titles,different cultures,different professions,randomly selected 5-6 nurses were interviewed,the results of interviews with the nursing staff of the hospital nursing adverse event views and opinionsbased onthe research.Results(1)The general situation:collect a total of 367 medical safety(adverse)medicalreports reported by the nursing department on January 2015-2016 December.The events were divided into 13 categories,and the top six nursing adverse events were:The Catheter Operation Events happened 113 cases(30.79%),Basic Care Events happened 89 cases(24.25%),Treatment of Error Events happened 49 cases(13.35%),Drug Dispensing Error Events happened29 cases(7.90%),Method of Technical Error happened 26 cases(7.08%),Information Transmission Error Event happened 18 cases(4.90%).(2)There were 42 nursing adverse events involving 24 departments.There were departments happenedmore 5 cases of nursing adverse events:Department of Neurosurgery in 28 cases,Department of Urology in 24 cases,the Old Age Surgery Department in 23 cases,Hepatobiliary and Pancreatic Surgery in 21 cases,21 cases of Cardiovascular Medicine,21 cases of Gastroenterology,etc.,the overall frequency of Surgery is higher than that of Internal Medicine.(3)The nursing adverse events happened quarter(a year)and time:second quarter,three quarter for multiple happened seasons,accounted for 60.75%;24:00-8:00 and 8:00-12:00 werethe highest period that the occurrence of nursing adverse events,accounted for 51.64%.(4)The incidence of adverse events was mainly in the elder,accounting for more than 77%.(5)The classification of adverse events:0 cases of grade I warning events,27 cases of secondary adverse consequences events(7.36%),318 cases not involved in bad results events(86.65%)and 22 cases of grade IV hidden dangers events(5.99%).(6)The nursing adverse events occurred responsibility person:the main responsibility person for the events is the young nurses,accounted for 84.18%;the main responsibility category:hospital workers,accounted for 68.12%;responsible work experience:mainly for less than 3 years,accounting for 42.51%.(7)The score of adverse events among nursesknown about the cognition of the medical safety(adverse)events:the highest score was 80 points(Full Score),with a minimum score of 15 points and an average of 59 points.(8)The different age,educational level,working years,technical titles,whether is the full-time supervisor of medical security(adverse)events,with the scores of cognitive of the nursing adverse events were statistically significant,P<0.05.The higher age,the higher education level,the higher working years,the higher technicaltitle,with the higher cognitive score.Age,educational level,working years and technical titles were positively related to the cognition of the nursing adverse events,P<0.05.Multiple regression analysis of the cognition of medical security(adverse)events in nursing staff:the main factors that affect the cognitive score of adverse events are department,technical title,whether is the full-time supervisor of the medical security(adverse)events.Conclusion(1)The Catheter Operating Events,Basic Care Events,and Treatment of Error Events are the high frequent incidents of the medical safety(adverse)events.(2)Department of Neurosurgery,Department of Urology,The Old Age Surgery,Hepatobiliary and Pancreatic Surgery,Cardiovascular Medicine,Gastroenterology and other departments of adverse events,the overall frequency of Surgery is higher than that of Internal Medicine.(3)The second,third quarter(a year),24:00-8:00 and 8:00-12:00 werethe highest period that the occurrence of nursing adverse events.(4)The elder patients are the major population happenedthe medical safety(adverse)events.(5)The III and IV events are the main levels of the incident events.(6)The low seniority,low professional titles and low education nurses are the main responsible persons for the nursing adverse events.(7)The cognition of the medical security(adverse)events among nursing staff is generally low and it needs to be further improved.(8)The age,education level,working years and professional titles have a great influence on the cognition degree of the medical security(adverse)events.Proposal(1)Strengthen the "four high"(high incidence,high incidence departments,high incidence time,elderly patients)supervision,do a good job in key links,reduce the occurrence of adverse events.(2)Improving the professional level of nursing staff,strengthening professional training and learning,and promoting continuing education.(3)Strengthen the construction of medical safety culture,improve safety awareness.(4)Improve the medical security(adverse)incident reporting/management system.(5)Strengthen the communication between doctors and patients and embody the service concept of "patient as the center".