Clinical Practice Tutor, Department of Interprofessional Studies, College of Human and Health Science, Swansea University, Swansea, UK.
J Nurs Manag. 2012 Sep;20(6):713-36. doi: 10.1111/j.1365-2834.2011.01276.x. Epub 2011 Aug 8.
The aim of the present study was to examine patient adverse events associated with sub-optimal patient moving and handling.
Few studies have examined the patient's perspective on adverse risk during manual handling episodes.
A narrative review was undertaken to develop the 'Dynamic Interaction Model of Patient Moving and Handling' in an orthopaedic rehabilitation setting, using peer-reviewed publications published in English between 1992 and 2010.
Five predominant themes emerged from the narrative review: 'patient's need to know about analgesics prior to movement/ambulation'; 'comfort care'; 'mastery of and acceptance of mobility aids/equipment'; 'psychological adjustment to fear of falling'; and 'the need for movement to prevent tissue pressure damage'.
Prevalence of discomfort, pain, falls, pressure sores together with a specific Direct Instrument Nursing Observation (DINO) tool enable back care advisers to measure quality of patient manual handling. Evaluation of patients' use of mobility aids together with fear of falling may be important in determining patients' recovery trajectory.
Clinical governance places a responsibility on nurse managers to consider quality of care for their service users. 'Dynamic Interaction Model of Nurse-Patient Moving and Handling' provides back care advisers, clinical risk managers and occupational health managers with an alternative perspective to clinical risk and occupational risk.
本研究旨在探讨与患者搬运和处理不当相关的不良事件。
很少有研究从患者的角度来评估在手动搬运过程中发生不良风险的可能性。
采用叙述性综述的方法，在骨科康复环境中，使用 1992 年至 2010 年间发表的同行评审英文出版物，开发了“患者搬运和处理的动态相互作用模型”。
从叙述性综述中出现了五个主要主题：“患者在移动/活动前需要了解止痛药”；“舒适护理”；“掌握和接受移动辅助工具/设备”；“对跌倒的心理调整”；以及“需要活动以防止组织压力损伤”。
不适、疼痛、跌倒、压疮的普遍存在，以及特定的直接仪器护理观察（DINO）工具，使背部护理顾问能够衡量患者手动搬运的质量。评估患者对移动辅助工具的使用以及对跌倒的恐惧可能对确定患者的康复轨迹很重要。
临床治理要求护士长考虑为服务使用者提供的护理质量。“护士-患者搬运和处理的动态相互作用模型”为背部护理顾问、临床风险经理和职业健康经理提供了一种替代视角，以考虑临床风险和职业风险。
