The application of smiling face logo can make some nurses change their ideas about quality and doing things, thus strengthening their safety awareness and service awareness, reducing accidents and providing patients with safe and high-quality nursing services. The following is a model essay on the application of self-made signs in risk management of psychiatric wards that I shared with you in J.L.
Objective: To design the psychiatric risk prevention signs independently, to improve nurses' awareness of risk prevention and reduce nursing risks. Methods: According to the common risk types in psychiatric department, smiling faces with different colors and sizes were pasted on bedside cards and lists for marking, so that nurses in each class could clearly understand the risk types of patients and provide targeted nursing measures. Results: after using smiley face symbol, the incidence of common risks of patients decreased (P < 0.05), and the main mental risks (suicide, violence and going out) decreased from 12% in 20 14 years to 8% in 20 15 years (p < 0.05). Conclusion: Smiling face logo is clear and eye-catching, easy to operate, beautiful and practical, which can warn and remind medical staff, prevent accidents, reduce the occurrence of adverse events and improve the quality of medical services, and can be popularized in clinic.
Keywords smiley face sign; Psychiatry; risk management
Psychiatric nursing is a high-risk and high-responsibility job. Due to the influence of mental symptoms or severe mental stimulation, patients with mental illness often have various critical events, such as suicide, self-injury, violent injury and going out. Or because of taking antipsychotic drugs for a long time, adverse reactions such as dysphagia, postural hypotension and excessive sedation may occur, thus increasing the risk of choking, falling and falling out of bed. This kind of behavior is hidden, sudden, impulsive and unpredictable. Correctly identifying and analyzing these risk factors is the premise of risk management. According to the practical experience of clinical work, our department independently designed the smiling face logo and applied it in clinic, which effectively improved the risk awareness and execution of nursing staff and reduced the occurrence of accidents.
1 objects and methods
1. 1 object
20 14 and 20 15 inpatients in our department were diagnosed as mental disorders, which met the diagnostic criteria of ICD- 10. Among them, there were 603 nursing risk patients in 20 14 years, including 3 17 males and 286 females, with an average age of 14-78 years (43.2? 14.9 years old. In 20 15 years, 69 1 person took care of patients at risk, including 378 males and 3 females, with an average age of 14-82 years (46.7? 16.2). The main diagnoses are schizophrenia, depression, bipolar disorder, alcoholic mental disorder and Alzheimer's disease.
1.2 design and application of risk prevention signs
1.2. 1 Our department designed five preventive signs according to common critical events in psychiatric department.
Uniform use of smiling face style, red smiling face to prevent self-injury and suicide, yellow smiling face to prevent impulsive injury and destruction, blue smiling face to prevent going out, purple smiling face to prevent falling out of bed, green smiling face to prevent choking and swallowing foreign bodies. The smiling face with a diameter of 1 cm is used on the list, and the smiling face with a diameter of 2 cm is used on the bedside card. Smiling faces of each color are fixed on the cards and lists at the bedside: red, yellow, blue, purple and green in turn.
1.2.2 Use of risk prevention signs
When the newly-admitted psychiatric patients are admitted, the nurses conduct adverse event risk assessment, including explicit aggression risk behavior assessment, suicide risk behavior assessment, fall risk assessment, walking risk assessment and suffocation risk assessment. According to the evaluation, there were 4 patients who were at risk of suicide in 20 14 years 105 people, and there were actually 4 cases. There were 2 19 patients at risk of violence, and 47 cases actually occurred; 178 cases were at risk of going abroad, and 9 cases actually occurred; There were 86 patients who were at risk of falling, and 9 cases actually happened; 15 people were at risk of suffocation, and 3 cases actually occurred. 20 15 years 127 cases, 2 cases actually occurred; There were 237 patients at risk of violence, and 36 cases actually occurred; 196 cases were at risk of going abroad, and 6 cases actually occurred; There are 1 14 cases with the risk of falling, and 6 cases actually happen; 17 people were in danger of suffocation, and 2 cases actually occurred. There was no statistical difference between the two groups (p & gt0.05), which was comparable.
Determine the risk level according to the evaluation score, and mark the smiling face on the bedside card and list. The nurse in charge evaluates the patient every day, and if the patient's condition improves and the risk is reduced, she tears off the corresponding smiling face; If the patient is seriously ill and has new risks, put on a corresponding smiling face. Shift change, so that nurses in each shift can clearly know the risks of patients.
1.3 statistical method
SPSS2 1.0 statistical software package was used for chi-square test and statistical analysis. P & lt0.05 indicates that the difference is statistically significant.
Two results
(1) By comparing the risk incidence of suicide, violence, going out, falling, suffocation and swallowing foreign bodies before and after using the smiley face logo in our department, 20 15 is lower than 20 14, as shown in Table 1.
(2) By comparing the total risk incidence before and after using the smiley face logo in our department, 20 15 was lower than 20 14, and the difference was statistically significant (P
3 discussion
(1) Nursing signs refer to the general name of industry characteristic signs that use standardized patterns and words to warn and remind nursing work in order to ensure the safety of clinical medical care and patients, and ensure the orderly progress of nursing work and effective improvement of nursing quality. The implementation of "three-prevention warning signs" is an advanced management method, which enables the staff in the ward unit to take effective intervention measures to prevent problems before they happen, so as to achieve the concept of prevention first. Standardized and eye-catching signs can give people a warning message, make people react and touch, and thus have an impact on people's thinking and behavior. The design of smiley face logo is eye-catching, giving people a sense of beauty, which fully embodies the scientificity, pertinence and artistry. The use of smiling face signs increases the risk awareness of nursing staff, enabling them to better evaluate patients and understand their real situation, so as to take targeted measures for patients at risk.
(2) In addition, the smiling face logo is easy to paste and remove, which is convenient for nurses to dynamically evaluate patients and change them in time according to the changes of patients' condition; Smiling face design reduces words, which not only reduces the workload of nurses, but also protects the privacy of patients, which is beneficial to the protection of patients' privacy, makes patients feel warm and caring, and fully embodies humanized nursing.
(3) In short, the application of smiley face logo can make some nurses change their concepts, change their quality concepts and work concepts, and then strengthen their safety awareness and service awareness, reduce the occurrence of accidents, and provide patients with safe and high-quality nursing services. However, due to the short use time of smiling face logo, its specific function needs further investigation and study.
refer to
[1] Li Lingjiang. Mental nursing [M]. Beijing: People's Health Publishing House, 2006: 6,2.
[2] Wang Xueling. Nursing Risk Management in Psychiatric Ward [J]. China Medical Science, 201(24):120-121,138.
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