新疆医科大学学报

目的探究结合现状及背景的评估建议(SBAR)方案联合改良早期预警评分(MEWS)模式对呼吸系统疾病患者管理的效果。方法以2019年10月—2021年3月儋州市人民医院收治的200例呼吸系统疾病患者为研究对象,按照首次入院的时间顺序进行编号,根据随机数字表法将不同编号患者分配至不同组别,其中对照组100例,住院期间采用常规患者评估、交班汇报的管理模式;观察组100例,采用MEWS评分对患者进行住院期间评估和安全管理,在汇报病情时采用SBAR方案进行沟通。记录两组患者的不良事件发生情况和护理质量评分情况,调查医护人员对患者病情掌握情况以及医生、患者分别对护士的工作满意度情况。结果与对照组相比,观察组患者的褥疮、给药错误、尿管脱落、感染等不良事件的发生率降低,差异有统计学意义(P<0.05)。与对照组相比,观察组患者的基础护理、病房管理和危重患者护理等方面的护理质量评分明显提高,差异有统计学意义(P<0.05)。与对照组相比,观察组医护人员在诊断和病情、异常化验结果、治疗、潜在风险和护理重点等方面的患者病情掌握评分均明显提高,差异有统计学意义(P<0.05)。与对照组相比,观察组患者家属和医生对护士的满意度均提高,差异有统计学意义(P<0.05)。结论 SBAR联合MEWS模式对呼吸内科患者进行评估管理,可减小医疗过程中人为不良事件的发生风险,提高医护人员的工作效率和质量,促进医护、护患交流沟通,增强医嘱执行力和患者的依从性,具有临床推广价值。

Objective To explore the effect of SBAR combined with improved early Warning Score(MEWS) model on the management of patients with respiratory diseases. Methods A total of 200 patients with respiratory diseases who were admitted to Danzhou People's Hospital from October 2019 to March 2021 were enrolled in this study and numbered according to the time sequence of the first admission. The different numbered patients were assigned to different groups according to the random number table method. 100 cases in the control group were treated with routine patient evaluation and shift report during hospitalization; For 100 cases in the observation group, MEWS score was used for inhospital evaluation and safety management, and SBAR scheme was used for communication when reporting the condition.The incidence of adverse events and nursing quality scores of patients in the two groups were recorded. The understanding of patients' conditions by medical staff, the job satisfaction of doctors and patients to nurses were investigated, and the results were statistically analyzed. Results Compared with the control group, the incidence of bedsore, administration error, drainage tube slippage, infection and other adverse events in the observational group were significantly decreased(P<0.05). Compared with the control group, the nursing quality scores of basic nursing, ward management and nursing of critical patients in the observational group were significantly improved(P<0.05). Compared with the control group, the observational group was significantly improved in terms of diagnosis and condition, abnormal laboratory results, treatment, potential risk and focus of nursing(P<0.05). Compared with the control group, the satisfaction of patients and doctors to nurses was significantly increased(P<0.05). Conclusion The SBAR combined with MEWS model for the assessment and management of patients in respiratory medicine can reduce the risk of human adverse events in medical process, improve the working efficiency and quality of health care workers, promote health care and nurse patient communication, enhance the enforcement of medical orders and patient compliance, and have clinical promotion value.