Study on the application of root cause analysis risk nursing management in clinical nursing

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Objective To investigate the effect of root cause analysis (RCA) risk nursing management in clinical nursing. Methods RCA method was adopted to analyze proximal causes and root causes of 124 clinical nursing problems occurred in this hospital from January to June in 2017, formulate and implement corrective measures. The incidence of adverse nursing events before and after implementation, the risk perception of nursing staff and patients' satisfaction with nursing quality were compared. Results The most common adverse events in clinical nursing mainly included treatment errors of doctor's orders, drug administration errors, venous puncture bleeding, pipe loss and skin compression, accounting for 18.55%, 14.52%, 13.71%, 9.68% and 6.45%, respectively.Proximal causes of adverse events include personnel factors and environmental factors, and the root cause is management factors (including unblocked communication channels, inadequate learning and training, unclear management process and imperfect management mechanism). RCA after implementation of nursing risk management, the incidence of adverse events by before the implementation of 4.817‰ after the introduction of reduced to 3.595‰ significantly lower incidence, and the difference was statistically significant (P=0.036). After the introduction of management, nursing risk perceptions implementation was obviously better than the former, patients satisfaction of nursing quality is obviously higher than that of before the implementation, and the difference was statistically significant (P<0.05). Conclusions Root cause analysis risk nursing management application in clinical nursing, can significantly reduce the incidence of adverse events, improve nursing staff risk awareness and patient satisfaction, the application effect is good. Key words: Root cause analysis; Risk management; Proximal cause; Root cause; Quality of care