摘要目的 将细节思维管理方法运用于重症监护病房( Intensive Care Unit,ICU)的护理管理中,分析应用效果.方法 选取2016年1月~2016年12月该院ICU未实施细节思维管理方法前收治的60例患者纳入对照组,选取2017年1月~2017年12月该院ICU采取细节思维管理方法时收治的60例患者作为观察组,最终两组分别58例、57例完成研究.评估细节思维管理方法实施前后的护理质量、护理文书书写质量、基础护理质量,调查科室护理人员参与护理的115例患者的满意度,统计期间压疮(包括难免压疮)的发生率及护理纠纷,分析细节思维管理方法的实施效果.结果 与对照组比较,观察组患者对护理工作满意度较高,差异有统计学意义(P<0. 05);观察组压疮的发生率低于对照组,护理纠纷发生率较低,差异有统计学意义(P<0. 05).实施细节思维管理方法后参与研究干预的30名护士在重症护理、护理安全、危重患者管理、抢救车管理、抢救药品器械、急救技能等方面评分均明显高于实施前,差异有统计学意义(均P<0. 05) ;细节思维管理方法实施后护理文书书写质量评分、基础护理合格率均有明显提高,差异有统计学意义(均P<0. 05) .结论 在ICU的护理管理中运用细节思维管理有助于培养护士的临床思维意识,减少护患纠纷,促进和谐护患关系的形成,同时优化管理流程,提高护理工作效率,改善护理质量.

abstractsObjective To apply the detailed thinking management method to the nursing management of Inten-sive Care Unit ( ICU) and analyze the application effect. Methods A total of 60 patients admitted to the ICU of the hospital from January 2016 to December 2016 before the implementation of the detailed thinking management method were selected as the control group. A total of 60 patients admitted to the ICU of the hospital from January 2017 to De-cember 2017 before the implementation of the detailed thinking management method were selected as the observation group. Finally, 58 patients and 57 patients in the two groups completed the study. The nursing quality, nursing docu-ment writing quality and basic nursing quality before and after the implementation of the detailed thinking management method were evaluated. The satisfaction of 115 patients in nursing department was investigated. The incidence of pres-sure sores ( including unavoidable pressure sores) and nursing disputes were statistically analyzed. The implementation effect of the detailed thinking management method was analyzed. Results Compared with the control group, the pa-tients in the observation group had high satisfaction with the nursing work, and the difference was statistically significant ( P<0. 05). The incidence of pressure sores in the observation group was lower than that in the control group. The inci-dence of nursing disputes was low, and the difference was statistically significant (P<0. 05) . After the implementation of the detailed thinking management method, 30 nurses who participated in the study intervention scored significantly higher in critical care, nursing safety, management of critically ill patients, rescue vehicle management, rescue drugs and instruments, and first-aid skills than before the implementation, with statistically significant differences ( P<0. 05). After the implementation of the detailed thinking management method, the qualified rate of basic nursing docu-ments were significantly improved, and the differences were statistically significant (P<0. 05). Conclusions The use of detailed thinking management in the nursing management of ICU helps to cultivate the nurses' awareness of clinical thinking, reduce disputes between nurses and patients, promote the formation of a harmonious nurse-patient relation-ship, optimize the management process, promote the efficiency of nursing work, and improve the quality of care.