基于PDCA循环的护理风险管理对长期住院精神障碍患者护理质量的影响OA
Study on the impact of PDCA—based nursing risk management on nursing quality in long—term hospitalized patients with mental disorders
目的:探讨基于循环质控理念的计划—执行—检查—行动(Plan-Do-Check-Act,PDCA)循环管理对精神科病房长期住院精神障碍患者不良事件发生率及护理质量的影响.方法:采用整群随机对照设计,将2023年1月至2023年12月705例长期住院的精神障碍患者分为试验组(362例)和对照组(343例).试验组实施PDCA循环管理护理模式,对照组实施常规护理模式,对比两种不同护理模式下患者不良事件率、护理人员风险防控意识以及护理质量的差异.结果:在为期1年的研究中,试验组不良事件总数为34起(9.39％),对照组不良事件总数为67起(19.53％),试验组的不良事件发生率明显低于对照组(x2=14.76,P＜0.001),差异具有统计学意义,试验组跌倒/坠床与暴力行为的发生率低于对照组(x2=5.36,4.64;P＜0.05),差异具有统计学意义,而自杀/自伤、饮食异常在两组之间的差异无统计学意义(P＞0.05).相较于对照组,在研究终点试验组护理人员的防控意识得分明显高于对照组(F=118.18,P＜0.05),试验组护理人员的防控行为得分明显高于对照组(F=199.93,P＜0.05),试验组护理人员的风险防控质量总分明显高于对照组(F=179.20,P＜0.05),差异具有统计学意义.结论:以PDCA循环管理为基础的护理风险管理,能显著减少精神科病房长期住院精神障碍患者的不良事件,并能够有效提高护理人员的护理安全性和护理质量.
Objective:To investigate the effects of Plan-Do—Check-Act(PDCA)cycle management based on the concept of continuous quality control on the incidence of adverse events and nursing quality in long-term hospital-ized psychiatric patients in psychiatric wards.Methods:A cluster randomized controlled design was adopted,in which 705 long-term hospitalized psychiatric patients from January 2023 to December 2023 were divided into an experi-mental group(n=362)and a control group(n=343).The experimental group received PDCA cycle-based nursing management,while the control group received conventional nursing care.The differences in adverse event rates,nurs-ing staff's risk prevention awareness,and nursing quality were compared between the two groups.Results:Over the one-year study period,the total number of adverse events was 34(9.39％)in the experimental group and 67(19.53％)in the control group.The incidence of adverse events in the experimental group was significantly lower than that in the control group,with a statistically significant difference(x2=14.76,P＜0.001).Specifically,the incidence of falls/bed falls and violent behaviors was lower in the experimental group than in the control group,with statisti-cally significant differences(x2=5.36,4.64;P＜0.05).However,no significant differences were observed between the two groups in terms of suicide/self-harm and abnormal eating behaviors(P＞0.05).At the study endpoint,the risk prevention awareness score of nursing staff in the intervention group was significantly higher than that in the control group(F=118.18,P＜0.05).The risk preventive behaviors score of nursing staff in the intervention group was also significantly higher than that in the control group(F=199.93,P＜0.05).Furthermore,the total risk prevention and control quality score of nursing staff in the intervention group was significantly higher than that in the control group(F=179.20,P＜0.05).Conclusion:Nursing risk management based on the PDCA cycle significantly reduces the inci-dence of adverse events in long-term hospitalized psychiatric patients in psychiatric wards and effectively improves nursing safety and quality.
胡晓芬;朱幸佳;朱明环;章蕾;陈发展;闵海瑛
同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124同济大学附属精神卫生中心(上海市浦东新区精神卫生中心) 200124
医药卫生
精神障碍计划—执行—检查—行动循环风险管理不良事件护理质量
Psychiatric disordersPDCARisk managementAdverse eventsNursing quality
《中国健康心理学杂志》 2026 (5)
641-646,6
上海市卫生健康系统重点学科建设项目(精神病学)(编号:2024ZDXK0011)上海市浦东新区卫生健康系统重要薄弱学科(精神科护理学)(编号:PWZbr2025-07)
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