Operation room is an important place for patients to carry out surgical treatment, the nursing work requirements are quite high, and the difficulty is relatively large, resulting in a variety of hidden risks [1].
During nursing in the operation room, surgery, anesthesia may be artificial to varying degrees of psychological harm, especially some of the neglect of self-protection, leading to the risk factors of nursing care to maintain the trend of annual growth of [2]. Therefore, it is necessary to prevent the existence of nursing risk, to ensure that the operation room nurse's physical and mental health, to ensure that nursing safety, to provide patients with quality care, to avoid all kinds of problems will cause medical disputes. In order to analyze the risk factors and preventive measures of nursing staff in operation room, we have implemented the full range of preventive measures, and the results are as follows.
1, data and methods
1.1, general information
Nursing staff of 48 cases, including 18 male and 30 female patients, aged 24~40 years old, average (27.06 + 2.63) years old. Working years in 1~5, the average work (3.04 + 1.24) years. The deputy director of 4 nurse, 10 nurse in charge, 28 nurses, 6 nurse. Cultural degree: 20 undergraduate degree, 18 college degree, 10 technical secondary school.
1.2, survey method
The questionnaire was designed by ourselves, and 48 questionnaires were distributed, 48 valid questionnaires were collected, the effective rate was 100%[3]. Take the self-made questionnaire, to carry out statistical nursing care satisfaction rate, complaint rate, error rate, risk rate. Service attitude, emergency ability, communication ability, communication ability, sense of responsibility, operation skill, writing standard and so on, score in 0~100 score, the higher the score, the better nursing quality.
1.3, the implementation of preventive measures
1.3.1, avoid the damage and strengthen disinfection management of sharps injuries generally appear young and lack of experience of nursing staff, therefore, should to the key to explain the cooperation, operation of various surgical emergency treatment knowledge, and invited out study nurses present trends of nursing knowledge to explain, organize new skills, new business training. While minimizing the use of chemical agents, should wear protective gloves and goggles when in contact with glutaraldehyde, avoid splashing into eyes or aspiration. To reduce the exposure of glutaraldehyde in the air, to be affixed to sterilization. Due to the operation in the operation room, nursing staff should always be exposed to formaldehyde, must wear protective gloves. In addition, the treatment of patients with blood, secretion and excretion. Due to the operation room nursing operation, the nursing staff often come into contact with the patient's blood, secretion and excretion. This requires that nursing personnel must wear the clothing and the double gloves when operating. If the patient's blood, secretion and excretion of the treatment is not good contact to the human body, must be promptly taken to rinse, and the use of saline to the mucosa of the rinse. In order to prevent the operation room from the reflection hazard, operation room with radiation prevention operation, machine operation, the need to line X line of surgery, before going on stage must wear lead coat, and in the operation of the security range of lead screen. The average arrangement of the number of nurses to participate in such operations, to avoid short-term exposure to large doses of X line. In the Department of orthopedics, the operation of alternating active and lower limb, usually to strengthen physical exercise, wear elastic stockings can effectively prevent the lower limb varicose veins. At the same time, strict aseptic technology, attention to the separation system, the safety of medical waste.
1.3.2, strengthening safety education, to reduce the risk factors of nursing care, we must strengthen the targeted safety education, the senior nurses to explain the problems in nursing care and related matters, at the same time to expand the operation of demonstration and skills assessment, to improve the nursing staff of nursing skills. In order to make the nursing staff to form a strong risk awareness, and enhance the standard of nursing writing, we must strengthen the management of nursing records, in order to reduce the incidence of nursing errors, in the case of litigation or disputes, provide effective legal evidence. In order to improve the professional level and comprehensive quality of nursing staff, it can encourage the nurses to continue their studies and enrich their knowledge of medical theory. At the same time, the performance evaluation in the inclusion of continuing education credits, to provide for the promotion, assessment title, continue to study and other platforms, and effectively enhance the enthusiasm of nursing staff.
1.3.3, care for the health of nurses, nursing staff of the amateur activity must be given to the operation room nursing staff to implement humanistic care, care for the health of the nurses, such as regular physical examination, in order to early detection and treatment of physical diseases, to ease the work of nursing staff pressure. At the same time, enrich the amateur activity of nursing staff, such as nurses in the management of regular organization to organize nurses to participate in the relevant sports activities, strengthen the contact between the various departments, and enhance the cohesion of the team, to build a harmonious, relaxed, positive work environment, forming a unity and mutual aid. In nursing work arrangement, understand the nurse's character, ability difference, reasonable allocation of work tasks, give the nurse life and emotional support, ensure the efficient deployment of the work. Operating room head nurse should make flexible scheduling work, appropriate adjustments to wash their hands and traveling times, to prevent nursing staff in excess load work. At the same time, a reasonable design of work flow, in order to reduce the work intensity of the nursing staff.
1.3.4, a clear incentive plan, improve the enthusiasm of the work of the first, the establishment of the feasibility of the rewards and punishments, to give performance outstanding performance of the material reward, improve the enthusiasm of nurses. Second, formulate the scientific system of rewards and punishments. Set achievable goals in nursing management, and encourage nurses to actively strive for the goals of the development. In the punishment of the design of the relevant rescue mechanism, according to the nurse's professional skills, working age and other conditions, to achieve a different treatment, and clearly the wrong reasons, to avoid the same mistake again. Third, to achieve a fair and transparent system of rewards and punishments. In order to enhance the transparency of the rewards and punishment system, it can be invited to participate in the supervision of nurses, to ensure the enthusiasm of nurses. As a manager must set an example, fair treatment of the nursing management problems, in order to further promote the system of rewards and punishments. In addition, the establishment of a non punitive nursing adverse event reporting system, so that the staff to form a strong risk awareness, enhance the standardization of nursing writing, to make up for the defects in the work, to reduce the rate of nursing errors.
1.3.5, improve the operation room nursing system, optimize the risk prevention system in the operation room management, and constantly improve and perfect the rules and regulations, can prevent the emergence of nursing risks in time, enhance the safety of nursing. Therefore, in order to solve the problems of nursing links, the system should be revised in order to solve the problems of easy to appear in the operation room. At the same time, optimize the risk prevention system, but also strengthen the potential risk factors of nursing in the operation room to analyze, in order to develop feasible corrective measures and preventive measures to reduce the occurrence of risk events. At the same time, improve their emergency response capabilities, communication skills, and the ability to operate, and strengthen communication between patients, carefully check the identity of patients, strict work shift work, and effectively improve the quality of care, standardize the use of various electrical equipment, to prevent the occurrence of burns, burns and other nursing risks, to protect the safety of operation room nursing.
1.4, statistics processing
Using SPSS 18 software for statistical analysis of the data, measurement data using the standard deviation (x- + s), said, compared with the t test, count data using the word 2 test, P<0.05 for the difference was statistically significant.
2, results
2.1, preventive measures before and after the implementation of nursing satisfaction rate, complaint rate, error rate, risk rate
After the implementation of preventive measures, nursing satisfaction rate was significantly higher than before the implementation of the complaint rate, error rate, the risk rate was significantly lower than before the implementation, the difference was statistically significant (P<0.05), see table 1.
Table 1 the nursing satisfaction rate, complaint rate, error rate, risk rate before and after the implementation of preventive measures
2.2, preventive measures before and after the implementation of nursing level changes in comparison
After the implementation of preventive measures, the nursing staff service attitude, emergency ability, communication ability, responsibility heart, the level of proficiency in the operation of the instrument, the written specification and other aspects of the score were significantly higher than before the implementation, the difference was statistically significant (P<0.05).
3, discussion
Sharp injuries, air pollution damage, physical damage, psychological problems such as nursing risk factors of nursing staff [4]. Mainly as follows: first, the sharp stab factors. In clinical surgery must use sharp instruments, need between doctors and nurses frequently transferred, in the transfer process, will inevitably hurt the nursing staff, resulting in the occurrence of hepatitis B, AIDS and other blood borne diseases. Nursing staff need to clean the operating equipment in a timely manner, in a little bit of cleaning will be injured by the device. Second, air pollution damage factor. Operation room need to use disinfectant or ultraviolet disinfection treatment, given the use of narcotic drugs, the drug will also cause the evaporation of volatile. In addition, surgery using high frequency electric knife from the smell, leakage of inhalation anesthesia of enflurane, isoflurane smell, will cause air pollution in operating room, to nursing staff skin, respiratory, nervous system caused varying degrees of damage. Third, physical damage factor. Nursing staff must be long time high input operation, fixed station in front of the operating table, keep the posture of the upper body leaning forward, neck long time biased towards one side, will increase the likelihood of cervical spondylosis, varicose veins and other diseases. This result is in line with the results of the clinical nurses in our country [5]. Fourth, psychological factors. Operation room work longer hours, nursing staff work busy, need to focus attention, shift frequency, easy to lead to the biological clock disorder, to the health of nurses seriously affect [6].
According to the nursing risk factors, taking into account the needs of nurses and social needs, so as to take corresponding preventive measures, so that the formation of nursing staff to protect the right sense of self-protection, and enhance the standardization of nursing operation procedures [7].
To ensure the health of patients and the health of patients and reduce the incidence of medical risks, and ultimately improve the satisfaction of patients to nursing [8-9]. Through the above research shows that after the implementation of preventive measures, nursing staff service attitude, emergency ability, communication ability, responsibility heart, the level of operation proficiency, nursing instrument writing standard, nursing satisfaction rate was significantly higher than before the implementation of the complaint rate, error rate, risk rate was significantly lower than before the implementation, the difference was statistically significant (P<0.05).
To sum up, analyze the nursing risk factors in operation room, and put forward the corresponding preventive measures, to reduce the incidence of nursing care, to prevent the occurrence of nursing risks, improve the satisfaction degree of patients in the whole, and establish the sustainable development strategy.
Reference test
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