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Objective@#To study the application of nurse-led management in the nursing safety quality of CCU transition patients.@*Methods@#The control group of 60 patients who were transferred to the general ward after CCU treatment in Wuhan University Renmin hospital from October to December 2017 was selected, and 60 patients from January to March 2018 were set as the experimental groups. The control group carried out routine nursing, and the experimental group adopted nursing leading management model to carry out nursing intervention. To observe and compare the quality of nursing safety, quality of life and satisfaction of patients before and after intervention.@*Results@#The nursing safety incidents, nursing gaps and CCU return rates of control group patients were 13.33%(8/60),23.33%(14/60) and 11.67%(7/60), respectively. For the experimental group patients, they were 3.33%(3/60),8.33%(8/60) and 3.33%(2/60), respectively. The difference was statistically significant (χ2= 4.415, 4.582, 4.312, P<0.05). After the intervention, the quality of life of the patients improved significantly. The conditions of physical function, emotional function, social function and overall quality of life of the control group were 56.07 ± 4.42, 66.62 ± 1.89, 56.34 ± 4.31, and 61.26 ± 4.15, respectively. For the experimental group, they were 71.88 ± 4.67, 73.52 ± 4.28, 63.94 ± 4.12, and 74.62±4.02, respectively. The difference was statistically significant(t=7.657-16.892, P<0.01). After the intervention, the patient's satisfaction also increased significantly. The control group′s psychological support dimension, cooperation dimension, and safety dimension were 7.96 ± 0.86, 7.39 ± 0.61, and 7.63 ± 0.16, respectively. For the experimental group, they were 9.56 ± 0.41, 9.08 ± 0.56, 9.21 ± 0.33, respectively. The difference between the two groups was statistically significant(t= 7.632, 9.116, 7.562, P<0.01) .@*Conclusion@#Nurse-led management can effectively improve the quality of care safety, quality of life and satisfaction of CCU transition patients, reduce the return rate of CCU, and provide clinical reference for safe care of CCU transition patients.
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Objective To study the application of nurse-led management in the nursing safety quality of CCU transition patients. Methods The control group of 60 patients who were transferred to the general ward after CCU treatment in Wuhan University Renmin hospital from October to December 2017 was selected, and 60 patients from January to March 2018 were set as the experimental groups. The control group carried out routine nursing, and the experimental group adopted nursing leading management model to carry out nursing intervention. To observe and compare the quality of nursing safety, quality of life and satisfaction of patients before and after intervention. Results The nursing safety incidents, nursing gaps and CCU return rates of control group patients were 13.33% (8/60),23.33% (14/60) and 11.67% (7/60), respectively. For the experimental group patients, they were 3.33%(3/60) ,8.33%(8/60) and 3.33%(2/60), respectively. The difference was statistically significant ( χ2 = 4.415, 4.582, 4.312, P<0.05). After the intervention, the quality of life of the patients improved significantly. The conditions of physical function, emotional function, social function and overall quality of life of the control group were 56.07 ± 4.42, 66.62 ± 1.89, 56.34 ± 4.31, and 61.26 ± 4.15, respectively. For the experimental group, they were 71.88 ± 4.67, 73.52 ± 4.28, 63.94 ± 4.12, and 74.62±4.02, respectively. The difference was statistically significant(t=7.657-16.892, P<0.01). After the intervention, the patient's satisfaction also increased significantly. The control group′s psychological support dimension, cooperation dimension, and safety dimension were 7.96 ± 0.86, 7.39 ± 0.61, and 7.63 ± 0.16, respectively. For the experimental group, they were 9.56 ± 0.41, 9.08 ± 0.56, 9.21 ± 0.33, respectively. The difference between the two groups was statistically significant (t= 7.632, 9.116, 7.562, P<0.01). Conclusion Nurse-led management can effectively improve the quality of care safety, quality of life and satisfaction of CCU transition patients, reduce the return rate of CCU, and provide clinical reference for safe care of CCU transition patients.
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Objective To explore the effect of nursing project management on the improvement of night nursing safety quality. Methods Totally 332 cases of inpatients from department of cardiovascular medicine, in accordance with the fore-and-aft sequence of implementing nursing project management, divided into experimental group (160 cases) and control group (172 cases). Through the nursing project improvement management, analyzing the reason of high incidence of adverse events related with the nursing safety at night in control group. Formulating standardized solutions to improve the quality of nursing safety at night. To compare the incidence of night nursing safety incidents, nursing defects and the prevention of nursing defects of the two groups before and after intervention. Results Experimental night nursing safety of nursing adverse events, gaps and prevent nursing defects were occurred in the experimental group 8.75％ (14/160), 10.00％ (16/160), 3.12％ (5/160), the control group after the interventionwere 1.74％ (3/172), 2.33％ (4/172), 11.04％ (19/172), the difference was statistically significant (χ2=6.904, 9.981, 10.626,P< 0.01). After the intervention, patients' self-management ability was enhanced, the experimental group patient compliance, psychological emotion, safety consciousness, rational drug use rate was 56.25％(90/160),52.50％(84/160), 62.50％(100/160), 67.88％(107/160), the control group 86.63％(149/172), 74.41％(128/172), 91.28％(157/172), 88.37％(152/172), the difference was statistically significant (χ2= 4.656- 10.756, P<0.01 or 0.05). Conclusion Nursing project management can effectively improve the quality of night nursing safety and self-management of patients, reduce the occurrence of nursing defects, and improve the safety of nightcare.
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This study described the nursing reform at Ningbo No.2 hospital under the guidance of JCI standards.According to the flat network structure, the quality and safety of nursing management was divided into 18 nursing management committees, each assigned to be responsible for a JCI section with specified performance-based distribution reform.Such indexes as nursing sensitivity were also analyzed. Given the workload pushed up by JCI standards,the performance-based reform rationalized the workload of nursing staff in its performance distribution reform, thus conducive to the implementation of the reform, higher nursing quality of care and less turnover rate.
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Objective To analyze the research hotspots and future trend of nursing safety. Methods Biclustering analysis was adopted to analyze the nursing safety literature in PubMed and Wanfang databases from 2012 to 2016 through the bibliographic contribution system BICOMB and graph clustering toolkit gCLUTO 1.0. Results Domestic nursing safety research fronts from 2012 to 2016 focused on adverse events,quality care services, quality evaluation indicators, work errors and safety culture. On the other hand,overseas nursing safety researches focused on system analysis, nursing quality sensitive indicators, teamwork and nursing safety, and the impacts of nursing work environment on quality and safety. Conclusions Comprehensive means of multi-disciplinary teamwork can be called into play for in-depth study of deloping adverse events assessment tools, establishing a unified nursing sensitive indicator system and continuous improvement. The future research trends are establishing a national standardized nursing adverse events reporting system, using information technology to build a big data platform for information sharing and exploring nursing safety from the security environment and organization management.
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Objective To understand the current status and influencing factors of nursing safety management of geriatric care institutions in Shanghai. Methods Adopted questionnaire and experts spot-supervision to survey 25 geriatric nursing hospitals and 12 community health care centers which had more than 200 beds. The questionnaire had four parts including nature of institutions, general information of the managers, nursing risk management status and nursing safety quality status. Results The average score of nursing safety quality was (14.12 ± 2.03) points, there was no statistical significance in nature of institution, size of the institutions, age, education background, professional title, managerial experience, effect of nursing risk report and assessment and contingency plan (P> 0.05), but there was statistical significance in nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training(F=2.818, 7.768, 3.555, P<0.05 or 0.01). Multiple linear regression showed that nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training were the influence factors of nursing safety quality, and they account for 82.1%, and the regression equation was Y=7.988+0.365X1-0.380X2+0.350X3. Conclusions Strength the construction of nursing management team, perfect nursing management system, regular training could improve nursing safety quality of geriatric institutions in Shanghai.
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Objective To establish nursing safety management system in the operating room and explore the effect of clinical application.Methods Toally 350 patients with surgical treatment from January to December 2013 were assigned as the control group,where routine nursing safety management was conducted.Another 350 patients from June 2014 to June 2015 were as the observation group,where nursing safety management system was used in the operating room.The two groups were compared in terms of adverse events,the passing rate of quality and safety.Result As compared with the contrast group,the incidence of adverse events was significantly lower and the passing rate of quality and safety was significantly higher in the observation group (P＜0.05).Conclusion Establishment of nursing safety management system can improve the nursing risk awareness,reduce the incidence of preoperative and postoperative adverse events and improve the level of nursing safety management and the quality of care.
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Objective To observe the Influence of improved ICU checklist on instrument management. Methods Reformed and improved the instrument delivery project in ICU checklist. The transfer situation from November 2014 to April 2015 as the control group.The situation from May to October in 2015 as the observation group.Compared the two groups of items of the transfer situation,the condition of nurses′ mastery of instrument parameters,the number of adverse events associated with the instrument and the satisfaction degree of the doctor on nursing work. Results Experimental instrument handover items in succession rate, incidence of adverse events, the doctor to nurse job satisfaction were 25.3% (278/1098), 6 cases, 93% (27/29), the control group were 59.6% (655/1098), 20 cases, 81% (17/21), the difference was statistically significant (χ2 = 264.868, 7.629, 70.046, P < 0.05 or 0.01). Conclusions Improved ICU checklist on instrument management can effectively promote nurses′mastery of instrument parameters, reduce the occurrence of nursing adverse events, ensure patient safety, improve the doctors′ satisfaction on nursing job, and provide an important basis for nursing safety management department.
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The authors introduced the development and application of an outpatient triage safety management system for hospitals. The system consists of the triage queue module, fast track module for prioritized special outpatients and subsequent outpatients, vital signs data recording module, assessment module for high fall risk outpatients, and high risk outpatient transfer module. These functions enable outpatient triage nurses to focus on pre-examination, safety factor identification, and high risk outpatient transfer, thus shortening outpatient queue time and high risk outpatient transfer to emergency, and lower adverse events. With this system, nursing safety management becomes more scientific, standardized and systematic, enabling optimized nursing staff efficiency and fine management of nursing care.
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The authors introduced the development and application of an outpatient triage safety management system for hospitals. The system consists of the triage queue module, fast track module for prioritized special outpatients and subsequent outpatients, vital signs data recording module, assessment module for high fall risk outpatients, and high risk outpatient transfer module. These functions enable outpatient triage nurses to focus on pre-examination, safety factor identification, and high risk outpatient transfer, thus shortening outpatient queue time and high risk outpatient transfer to emergency, and lower adverse events. With this system, nursing safety management becomes more scientific, standardized and systematic, enabling optimized nursing staff efficiency and fine management of nursing care.
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Objective To explore the method and effect of checklist tool implemented in the safety management of clinical blood transfusion in intensive care unit. Methods A checklist was specially designed according to the technical standard and check system of clinical blood transfusion. 379 patients prescribed a blood transfusion enrolled in ICU from January to May 2013 were conducted as the control group before the checklist was designed. After the application of checklist during the blood transfusion process, 846 patients prescribed a blood transfusion enrolled in ICU from June to December 2013 were conducted as the experimental group. The incidence of blood transfusion safety related adverse events between the two groups was compared. Results The incidence of adverse events was 1.32% (5 of 379 patients) in the control group, and there was no sign of adverse events occurred in the experimental group. The difference had statistical significance (χ2=11.21, P<0.05). Conclusion The application of checklist reduced the incidence of blood transfusion safety related adverse events,and effectively improved the quality of nursing safety and patient satisfaction.
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Objective To explore the role of state-level continuing education courses of oper-ation-room nursing in improving the nursing safety cognition in nursing staff. Methods The state-level continuing education programs about the operating room safety and quality management were held for five sessions from Jan 2007 to Dec 2012, in which a total of 641 people participated. All participants were examined before and after each training session. The scores of the examination were utilized to evaluate the cognitive level of the operation-room nusring safety. Results Compared with before training, the students' scores after training were significantly elevated(P<0.05); compared with that after one training session, the students' scores after four and five training sessions were markedly increased(P<0.05). After hospitals sending representatives to participate in the training, their operat-ing room adverse events were decreasing. Conclusion Holding the state-level continuing education programs about operating room safety and quality management helps the nurse staff improve the cogni-tive level of operation-room nursing safety, and their cognitive level can be reinforced after receiving repeated training sessions. Moreover, holding the continuing education programs can decrease the in-cidence of adverse events and the complications in the operation-room.
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Objective To investigate effect of Murphy's law on the nursing safety management of the hemodialysis patients. Methods 4598 hemodialysis cases in a blood purification center of a first class grade A hospital from April to July in 2011 was assigned as pre-implementation group.Then Murphy's law was used in the nursing practice.In the following,another 5683 hemodialysis cases from November in 2011 to January in 2012 were assigned as post-implementation group.The incidence of nursing risks and hemodialysis equipment failures were compared between the two groups.Result The incidences of nursing risks and hemodialysis equipment failures in the post-implementation group were significantly lower than those of the pre-implementation group(P<0.05).Conclusions Murphy’s law is effective for the declines of nursing manipulative defects and hemodialysis equipment failures.Besides,the law can be good for the strengthened awareness of safety and enhanced consciousness of all staff participating in the safety management so as to ensure the safety and quality of hemodialysis.
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Objective To investigate the application of education of nursing safety in nursing technique teaching.Methods 60 cases of new entry nursing personnel in our hospital from December 2009to June 2010 were divided into the observation group and the control group,the control group was given traditional teaching methods of training and evaluation,the observation group was given nursing safety education on the basis of the control group.The evaluation of teaching methods,the testing score 1 year later and incidence rate of adverse events between two groups were compared.Results The observation group believed that their ability in the discovery,analysis,solving of the problems of nursing safety was enhanced by teaching.Theoretical examination results between two groups had no significant difference.But technique assessment score in the observation group was significantly higher than that in the control group,the incidence of adverse nursing events was significantly lower than that in the control group.Conclusions The nursing safety education helps to improve the foresight ability in nursing safety,improve the occupational quality and ensure patients' safety.
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Objective Through analyzing the causes of iodine contrast agent extravasation,nursing managers develop effective solutions timely and take appropriate precautionary measures to ensure the safety of patients effectively.Methods 600 patients undergoing CT contrast enhanced scan were selected,300 patients from May 2009 to April 2010 were set as the control group and were given routine nursing care,300 patients from May 2010 to April 2011 were set as the study group and they adopted effective preventive measures.The incidence of adverse events after injection of iodine contrast agent between the two groups was compared.Results The incidence of iodine contrast medium extravasation in the study group was significantly reduced to 2％ after taking a series of preventive measures,which was lower than 10％ of the control group.Conclusions Taking a series of preventive measures can reduce the incidence of adverse events of iodine contrast agent extravasation,ensure the safety of patients,decrease the frequency of nursing complaints and nursing deficiencies,as well as improve the quality of nursing service.
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Objectives Using the theory and method of feedforward control management to control the blind spot of nursing safety of preoperative fasting time for children,so that the actual preoperative fasting time for children is close to the standard preoperative fasting time.Methods We established preoperative fasting nursing procedure according to feedforward control based on reasons for common long preoperative fasting time of infants facing expected operation from September 2005 to September 2006.Children facing expected operation were divided into the experimental group(66 cases)and the control group(58 cases).They adopted preoperative fasting nursing procedure after feedforward control and the traditional nursing procedure respectively.Preoperative fasting time between the two groups was compared and analyzed.Results There was significant difference about the preoperative fasting time between the two groups,P＜0.01.The actual preoperative fasting time for infants in the experimental group was close to the standard fasting time.Conclusions Using preoperative fasting nursing procedure with feedforward control,the blind spot of nursing can be partially emilinated,and the actual preoperative fasting time for infants is close to the standard.