Application of the management mode participated by doctors, nurses and patients in the safety management of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit_West China Medical Journal

Authors：

LIU Yan , WU Menghang ,  LIU Fan

Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Fan, Email: samotj@163.com

Keywords：

Management mode participated by doctors, nurses and patients; Neurosurgery Intensive Care Unit; Restlessness patients; Safety management of medical tubes

DOI：

10.7507/1002-0179.201505004

Video：

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Objective To determine the effects of the management mode participated by doctors, nurses and patients on the safety of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit (NICU). Methods A total of 133 restlessness patients treated between May 17 and November 22, 2013 were included in the study as control group, who were admitted to the NICU before application of the management mode participated by doctors, nurses and patients; another 119 restlessness patients treated between May 17 and November 22, 2014 were included in the study as research group, who were admitted to the NICU after application of the management mode participated by doctors, nurses and patients. Then we compared the accidental extubation situation between the two groups. Results The accidental extubation rate of all kinds of medical tubes in the research group was lower than that in the control group, among which the extubation rate of urethral catheter (0.67% vs. 4.32%), gastric tube (2.26% vs. 10.14%), trachea cannula (1.08% vs. 7.84%), and arterial cannulation pipeline (1.12% vs. 6.93%) was significantly different between the two groups (P<0.05). Conclusion The management mode participated by doctors, nurses and patients can effectively reduce the accidental extubation rate of medical tubes for restlessness patients, prevent the occurrence of adverse events and ensure the treatment and nursing safety in the NICU.

Citation： LIUYan, WUMenghang, LIUFan. Application of the management mode participated by doctors, nurses and patients in the safety management of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit. West China Medical Journal, 2017, 32(2): 242-245. doi: 10.7507/1002-0179.201505004 Copy

1.	吴孟航, 刘帆, 王琼. NICU 意外拔管护理风险防范策略. 现代预防医学, 2014, 41(11): 2110-2112.
2.	Morhard D, Fink C, Graser A, et al. Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol, 2009, 44(5): 293-297.
3.	张娜, 郭敏, 王永勤. 神经外科护理风险的分析及防范对策. 中国医药指南, 2014, 12(30): 310-311.
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7.	李燕芬, 郑再菊. 神经外科管道护理风险因素分析及防范对策. 护士进修杂志, 2010, 25(13): 1210-1211.
8.	毕勇志. 重症医学科患者意外拔管的原因分析及防范对策. 中外医疗, 2014, 33(4): 166, 168.
9.	范春芳, 顾玲妹, 朱文亚. 重症监护室患者非计划性拔管的原因分析与护理. 实用心脑肺血管病杂志, 2013, 21 (3): 152-154.
10.	申启兰, 郭菊, 王树红, 等. 护理不良事件信息化管理系统在基层医院患者安全管理中的应用. 华西医学, 2015, 30(9): 1733-1735.
11.	徐琳琳. 医护患一体化方案对胶质瘤患者护理质量的影响. 中国肿瘤临床与康复, 2014, 21(4): 510-512.
12.	杨旸, 辛文琼. 系统性护理干预在腹腔镜下小儿美克尔憩室切除术中的应用. 华西医学, 2016, 31(1): 148-150.
13.	蒋海兰, 刘冰, 曹敏, 等. 护理产房实施医护患一体化模式的效果评价. 解放军护理杂志, 2010, 27(3A): 348-349.
14.	强小娜, 漫丽, 柴菊丽. 老年食道异物 17 例医护患一体化的护理. 中国误诊学杂志, 2009, 9(5): 1144-1145.
15.	刘迎. 我院实施医护患一体化改革的做法与体会. 中华医院管理杂志, 2002, 18(1): 47-48.
16.	王淑, 奚益群, 魏明月, 等. 基于医院信息平台的医护患一体化互动模型的研究. 中国卫生资源, 2014, 17(5): 370-372.
17.	刘霞, 兰尧, 刘静, 等. 医护一体化在肝癌患者介入治疗中的应用. 华西医学, 2014, 29(11): 2135-2137.
18.	朱月琴. ICU 气管插管患者发生意外拔管的风险因素与防范对策分析. 当代医药论丛, 2014, 12(16): 84-85.
19.	朱忠琴, 管军, 董浩芬, 等. 人工气道患者意外拔管的原因分析及护理对侧. 解放军护理杂志, 2003, 20(7): 63-64.
20.	封苏平, 郑红, 姜国英, 等. 保护性榆树对脑损伤躁动患者意外拔管的预防效果. 解放军护理杂志, 2010, 27(3A): 343-347.

1. 吴孟航, 刘帆, 王琼. NICU 意外拔管护理风险防范策略. 现代预防医学, 2014, 41(11): 2110-2112.
2. Morhard D, Fink C, Graser A, et al. Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol, 2009, 44(5): 293-297.
3. 张娜, 郭敏, 王永勤. 神经外科护理风险的分析及防范对策. 中国医药指南, 2014, 12(30): 310-311.
4. Cumbie A. The integration of mind-body-soul and the practice of humanistic nursing. Holist Nurs Pract, 2001, 15(3): 56-62.
5. Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf, 2006, 32(3): 167-175.
6. Bello J, Quinn P, Horrell L. Maintaining patient safety through innovation: an electronic SBAR communication Tool. Comput Inform Nurs, 2011, 29(9): 481-483.
7. 李燕芬, 郑再菊. 神经外科管道护理风险因素分析及防范对策. 护士进修杂志, 2010, 25(13): 1210-1211.
8. 毕勇志. 重症医学科患者意外拔管的原因分析及防范对策. 中外医疗, 2014, 33(4): 166, 168.
9. 范春芳, 顾玲妹, 朱文亚. 重症监护室患者非计划性拔管的原因分析与护理. 实用心脑肺血管病杂志, 2013, 21 (3): 152-154.
10. 申启兰, 郭菊, 王树红, 等. 护理不良事件信息化管理系统在基层医院患者安全管理中的应用. 华西医学, 2015, 30(9): 1733-1735.
11. 徐琳琳. 医护患一体化方案对胶质瘤患者护理质量的影响. 中国肿瘤临床与康复, 2014, 21(4): 510-512.
12. 杨旸, 辛文琼. 系统性护理干预在腹腔镜下小儿美克尔憩室切除术中的应用. 华西医学, 2016, 31(1): 148-150.
13. 蒋海兰, 刘冰, 曹敏, 等. 护理产房实施医护患一体化模式的效果评价. 解放军护理杂志, 2010, 27(3A): 348-349.
14. 强小娜, 漫丽, 柴菊丽. 老年食道异物 17 例医护患一体化的护理. 中国误诊学杂志, 2009, 9(5): 1144-1145.
15. 刘迎. 我院实施医护患一体化改革的做法与体会. 中华医院管理杂志, 2002, 18(1): 47-48.
16. 王淑, 奚益群, 魏明月, 等. 基于医院信息平台的医护患一体化互动模型的研究. 中国卫生资源, 2014, 17(5): 370-372.
17. 刘霞, 兰尧, 刘静, 等. 医护一体化在肝癌患者介入治疗中的应用. 华西医学, 2014, 29(11): 2135-2137.
18. 朱月琴. ICU 气管插管患者发生意外拔管的风险因素与防范对策分析. 当代医药论丛, 2014, 12(16): 84-85.
19. 朱忠琴, 管军, 董浩芬, 等. 人工气道患者意外拔管的原因分析及护理对侧. 解放军护理杂志, 2003, 20(7): 63-64.
20. 封苏平, 郑红, 姜国英, 等. 保护性榆树对脑损伤躁动患者意外拔管的预防效果. 解放军护理杂志, 2010, 27(3A): 343-347.

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