Abstract:

Objective To analyze the risks in a temporarily renovated ICU at Tongji Hospital in Wuhan using the Hazard Vulnerability Analysis based on the Kaiser Model,and to propose strategies to respond and manage the risks. Methods The risk management index evaluation system for nursing management was developed based on the Kaiser Model and the status of the temporarily renovated ICU at Tongji Hospital. It was surveyed via web questionnaires during Feb 21st to 25th,2020 among the medical teams in the ICU,and the index risk value and matrix distribution were analyzed. Results The top 13 risk events perceived by the medical team were listed as following.C8 nurses needle stick injury（0.447 6）,B1 patients need to be rescued （0.413 0）,C10 nurses being infected （0.411 0）,B2 patients’ psychological problems（0.407 4）,C9 doctors being infected（0.359 8）,E3 insufficient or interrupted oxygen supply（0.329 1）,D9 drug shortage（0.324 2）,E2 insufficient protective equipment（0.317 9）;C12 doctors and nurses’ absence from work due to emergency illness（0.309 1）,C7 doctors needle stick injury（0.298 2）,E1 insufficient supporting staff in the hospital（0.293 5）,B6 adverse drug reactions in patients（0.292 4）,C6 nurses’ psychological maladjustment（0.289 1）. Conclusion Managers should pay attention to the risk assessment on the status of the temporarily renovated ICU at Tongji Hospital,and then guide the problem solving; at the same time,they should attach great importance to the occupational protection and physical and mental health of medical staff.

Key words: Coronavirus Disease 2019, Nursing Management, Kaiser Model, Hazard Vulnerability Analysis

摘要：

目的 对同济医院中法新城院区某重症病区进行护理管理灾害脆弱性分析,了解新型冠状病毒肺炎疫情下护理管理现存的风险,明确应急管理方向。方法 以基于Kaiser模型的灾害脆弱性分析为指导,结合整建制接管的重症病区实际运行管理情况,制订护理管理风险事件指标评价体系,于2020年2月21日—25日通过网络问卷进行调查,并对指标风险值和矩阵分布进行分析。 结果 风险值提示,以下事件需重点关注：C8护士发生针刺伤（0.447 6）、B1患者突发病情变化需抢救（0.413 0）、C10护士被感染（0.411 0）、B2患者不良的心理状态（0.407 4）、C9医生被感染（0.359 8）、E3氧气压力不足或中断（0.329 1）、D9药品供应短缺（0.324 2）、E2职业防护装备不足（0.317 9）、C12医护人员因急患疾病导致无法正常工作（0.309 1）、C7医生发生针刺伤（0.298 2）、E1工勤人员不足（0.293 5）、B6患者发生药物不良反应（0.292 4）、C6护士心理调适不良（0.289 1）。 结论 护理管理者要对新型冠状病毒肺炎重症病区的风险指标进行风险评价,进而指导分类施策;同时,要高度重视医护人员的职业防护和身心健康。

关键词: 新型冠状病毒肺炎, 护理管理, Kaiser模型, 灾害脆弱性分析