The Application Of 5M1E Analysis Method In The Nursing Safety Management Of Hospital

Objectives:1. To understand the main reasons of the hospital nursing adverse events in nursing safety management, and the proportions of5M1 E factors account for; 2. To understand the cognition degree of Shenzhen hospitals’ nursing staff on nursing safety management knowledge.Methods: 1. Literature analysis method. To explore nursing safety management theory research progress at homeland and abroad, staring from the concept, classification, present situation and problems,combining with 5M1 E analysis method of related concepts, providing theoretical basis and reference model for our country’s current hospital nursing safety management. 2. Survey method. Using the method of retrospective analysis and 5M1 E analysis to analyze relevant data in hospital nursing adverse event reporting system, sums up risk factors and preventive measures in hospital nursing safety management which the5M1 E analysis method involved. 3. The questionnaire survey method.Quantitatively extract related 5M1 E influence factors,present situation and problems, the cognition degree, advice of nursing staff, nursing management personnel in hospital nursing safety management,providing statistics and reality basis for the perfection of hospital nursing safety management.Results: 1. According to the 5M1 E factors which affect hospital nursing safety management, the percentage is in a order of man, measurement,environment, method,material, machine. Man factor accounted for88.17% of the nursing safety management related risk factors, and it was divided into four factors-- nursing operator, patient, accompany, nursing managers. The adverse events which due to the nursing operator is67.84%. The main reasons are short of assessment---15.90% and careless checking-- 15.16%. And then was the patient factor-- 14.42%, followed by accompany factor-- 3.88%. The main reason was lack of knowledge.At last it was the nursing managers factors--2.03%. The main reason was improper management.Measurement was the quality control training factors, which accounted for 5.18%. The main reason was that training didn’t meet the requirement. Environment was the environment and link factors-- 4.99%. The main reason was frequently adding the extra beds or moving beds. Method was rules and process plan factors-- 0.74%. The main reason was imperfect rules or processes. Material factor was medicine and medical devices. The main reason was improper preservation. It accounted for 0.55%. Machine factor was equipment--0.37%. The main reason was the fault errors. 2. To develop a set of hospital nursing safety management cognition questionnaire which includes 54 items and 8 dimensions. Eight dimensions’ Cronbach ’s reliability coefficient were as follows: the risk awareness of nursing safety--0.933, nursing safety management knowledge-- 0.897, nursing adverse events related knowledge-- 0.865, conventional safety knowledge of daily nursing work-- 0.924, drug safety management--0.899, nursing safety regulations-- 0.915, nursing safety process plan--0.943, nursing safety training and quality check-- 0.947, total questionnaire-- 0.869. The Cronbach’ s coefficient was 0.857 which based on the standardization. Total questionnaire’s CVR structure validity was 0. 875. Eight dimensions were as follows: the risk awareness of nursing safety--0.869, nursing safety management knowledge-- 0.837, nursing adverse events related knowledge-- 0.854,conventional safety knowledge of daily nursing work-- 0.892, drug safety management-- 0.784, nursing safety regulations-- 0.866, nursing safety process plan-- 0.883, nursing safety training and quality check--0.794. Structure validity of KMO value was 0.866. Using principal component method to extract the characteristic roots of the 8 common factors which were > 1, their total variance were 79. 59%. Questionnaire had good reliability and validity. 3. All of the Shenzhen nursing staff had cognition on the three entries "potential law problems in nursing work" "the rights and obligations of the nurse" "every duty ’ s responsibilities and specific work processes", while they had some blind spots on the other 51 entries in different degrees. In the top 15 high percent’s entries of Nursing safety management which nursing staff selected the optional "I don’t know", "no training and learning" was more common than "forget after training and learning". "no regime and training", "no regime,forget after training" were more common than "no training and learning" and "forget after learning the regime". Nursing staff’s general information such as age, nursing work experience, technical titles,academic degree were positive correlation with cognition on nursing safety management knowledge. But gender, marital status, clinical departments has no relationship with cognition on nursing safety management. Nursing safety training frequency and nursing safety quality inspection frequency had significant correlation with the incidence of nursing adverse events.Conclusions: 1.Controlling man-made nursing safety problems,improving hardware factors, increasing nursing safety management core elements, improving software factors, improving comprehensive quality of nursing safety can effectively reduce the incidence rate of nursing adverse events.2. Strengthen training and quality inspection can significantly improve the quality of nursing safety management. 3.Cognition questionnaire on hospital nursing safety management knowledge can get a comprehensive understanding of nursing staff’s cognition degrees on hospital nursing safety management knowledge,providing basis for improving nursing safety management.