主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
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基于JCI标准对住院精神分裂症患者攻击行为实施管理的实践

王桂梅 解红文 朱琳娜 谢红芬 罗娟   

  1. 镇江市精神卫生中心护理部
  • 出版日期:2015-04-25 发布日期:2015-04-25

The practice effects of aggressive behavior management under Joint Commission International standards among inpatients with schizophrenia

  • Online:2015-04-25 Published:2015-04-25

摘要: 目的:探讨JCI 标准下住院精神分裂症患者攻击行为管理的实践效果。方法:对本院2013 年1-12 月具有攻击行为的80 例精神分裂症患者进行3 周的美国医疗机构评审联合委员会国际部(JCI) 标准管理,建立风险管理小组、完善攻击培训,进行全面系统评估、追踪评价并持续质量改进。结果:改进后,攻击风险等级为III 级的患者从13.75% 降至6.25% ;IV 级从11.25% 降至3.75% ;修改版外显攻击行为量表(MOAS) 各因子得分及最后设置的加权总分与改进前有统计学差异(P <0.01);护士用住院患者观察量表(NOSIE) 各因子得分与改进前有统计学差异(P <0.05)。结论:JCI 标准管理有助于减轻患者的易激惹性,提高社会兴趣,促进社会能力的恢复;降低患者攻击风险等级,减少攻击行为的发生,保障护理安全。

Abstract: Objective: To explore the practice effects of aggressive behavior management under Joint Commission International (JCI) standards among in-patients with schizophrenia Methods: We recruited 80 cases with aggressive behavior among schizophrenic patients and managed them under JCI standards for 3 weeks. We established risk management team,improved attack training, assessed systematically and comprehensively, and evaluated and improve the quality continuously.Results: Attack risk assessment indicated that we reduced risk grade III from 13.75% to 6.25% and risk grade IV from 11.25% to 3.75% after using JCI management. There were significant difference between the scores of each factor and total weighted score of Modified version of the overt behavior scale (MOAS), and the scores of each factor of Nurses Observation Scale for Inpatinent Evaluation (NOSIE) before and after intervention (P<0.01). Conclusion: JCI standard management could reduce the irritability and hostility of patients, improve their social interests, promote their social ability recovery, reduce their attack risk grade, reduce the occurrence of aggressive behavior, and guarantee nursing safety.