应用风险评估表筛选并确立风险预警机制的意义

目的：本研究对目前临床护理工作风险评估表单进行整理，筛选风险因素，建立一套综合的、量化的风险预警机制，为推动医院风险管理，减少医患纠纷提供可借鉴的方法。方法：通过中国知网、中文维普网及万方数据库检索护理风险事件涉及的跌倒、压疮、精神方面及基础健康状况等方面的相关报道，结合风险评估表单。采用德尔菲（Delphi）法进行专家咨询，并根据专家意见调整表单内容，筛选出风险预警指标、确定各级指标权重、建立护理风险评估表。结果：护理风险综合评估表包括：两项一级指标，自然因素和住院因素；14项二级指标，年龄、饮食、皮肤、视力、活动、排便、神志、心理意识、理解沟通、疼痛、疾病诊断、管道、用药、穿刺针类型及部位；34个程度分级。结论：临床护理风险因素预警指标的确立为临床护理风险评估和管理提供了科学的依据，为建立护理风险评估管理信息化系统打下了基础。

Significance of Selecting and Establishing the Warning System for Nursing Risks by Assessment Tables＊

Objective： This study aims at the risk assessment forms applied on the clinical nursing and screen the factors that led to risks for nursing in order to establish a comprehensive evaluating system for the management of medical risks in hospital. Methods： The related risk events reporting about the fall, the pressure sores, the mental and physical health, etc. were collected by searching the CNKI, the Chinese VIP and the Wanfang database, as well as the present assessment scales for nursing risks. According to the Delphi method, the warning indexes and content were designed after investigating the expert opinions, then the index weight was determined and the nursing risk assessment was established. Results： The final comprehensive care risk assessment scale which includes the two first-level factors, namely, the natural factors and the admission factors; 14 second-level factors were the age, the diet, the skin, the vision, the activ- ity, the cacation, the consciousness, the psychological state, the ability of communication and understanding, the pain, the diagnosis, the pipelines, the medication, the puncture needle type and position with three grades. Conclusions： The establishment of warning system for risk factors in clinical nursing work could provide a scientific basis for the assessment and management of nursing risk and make contri- bution to the foundation of management information system.