預警式評分系統對老年骨折患者護理效果及不良事件發生風險的影響研究*

□ 陳琰琰 CHEN Yan-yan 陶愛萍 TAO Ai-ping 劉曉莉 LIU Xiao-li

Objective To explore the effect of early warning scoring system on nursing effect and risk of adverse events in elderly patients with fracture.Methods Forty-nine elderly patients with fracture admitted to the 2nd Affiliated Hospital of Wenzhou Medical University from October 2014 to November 2015 were randomly selected as the routine group. And 49 patients admitted from December 2015 to November 2016 were selected as the intervention group. Routine care was carried out in the routine group. Patients in the intervention group were intervened with early warning scoring system. The nursing effects and incidence of adverse events were compared between the two groups. Results The intervention group yielded significantly better nursing effect and lower incidence of adverse events than the routine group, and the difference was statistically significant (p＜0.05). Conclusion Nursing intervention with early warning scoring system can improve the nursing effect and reduce the incidence of adverse events in elderly patients with fracture.

隨著我國社會人口老齡化進程的加速，老年骨折患者呈逐漸增長趨勢[1]。由于老年骨折患者具有病情變化快以及創傷情況復雜等特點，護理人員對老年骨折患者所存在的風險因素缺乏相應的評估能力，易導致不良事件的發生[2]。護理人員的臨床經驗及對患者生命體征的監測，是目前臨床上護士向醫師反映患者病情的主要依據，由于缺乏科學的、量化的預警提示，極易導致醫護溝通信息缺乏準確性，直接影響到患者治療的準確性與時效性[3]。預警式評分系統(Early Warning Scoring System，EWSS)是一種以提高疾病危險程度的鑒別為目的的簡便、高效的評分系統[4]。目前，臨床上應用EWSS的最大優勢在于，其評估結果以及分值的精確設定可作為制定相應的治療、護理干預措施的依據，從而使護理管理工作有的放矢，高效實施[5]。EWSS主要是通過觀察及賦值所選定的患者的臨床生理參數，并將所選定生理參數的評分進行統計分析，由此得出早期預警評分分值，與觸發值比較后啟動對應級別的干預方案[6]。杜娜[7]相關研究報道，EWSS對于專科以及綜合病房患者的病情及預后的評估具有一定的安全性及實用性。本研究對老年骨折患者實施常規護理管理模式及預警式評分系統管理模式進行護理干預，分析比較兩組患者的臨床護理效果以及不良事件的發生率。經研究發現，干預組患者的臨床護理效果顯著，不良事件的發生率較低，總體效果較為滿意。……