Wu Yanru, Jing Mengmin, Yang Haiqin, Liu Juan, Zhang Tiantian, Zhu Hui, Yang Yajuan, Gao Chunyan
Department of Anesthesiology, Changzheng Hospital, Affiliated to Naval Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
Department of ophthalmology, Changzheng Hospital, Affiliated to Naval Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
BMC Surg. 2025 Apr 7;25(1):141. doi: 10.1186/s12893-025-02877-x.
The study evaluates the clinical value of the operating room nursing safety management model based on Heinrich's law.
A quasi-experimental design with a historical control group was conducted at Changzheng Hospital. A total of 240 surgical patients (pre-intervention: n = 120, December 2021-2022; post-intervention: n = 120, January-December 2023) were recruited via convenience sampling. The intervention included standardized protocols, mobile nursing systems, electronic specimen labeling, and equipment management. Quantitative outcomes were analyzed using χ² tests (adverse events), independent t-tests (nursing competency scores), and logistic regression (risk factors). Patient satisfaction was assessed via a validated self-report questionnaire.
The results showed a significant reduction in the incidence of operating room nursing safety accidents and a significant improvement in the specific nursing, identification, management of specimens, health education, safety awareness and operational skills of the nursing staff after the implementation of the operating room nursing safety management model based on Heinrich's law (P < 0.05).The management model implemented in the operating room had a positive impact on nursing safety, as evidenced by the significant improvement in patient satisfaction (P < 0.05). Logistic multifactorial regression analysis identified several key factors that affect nursing care safety in the operating room, including the nursing staff's business ability, legal awareness, the operating room environment, and the management system.
The Heinrich's law-based model effectively enhances perioperative safety by reducing errors, improving nursing competency, and increasing patient satisfaction. Clinically, we recommend integrating standardized protocols with mobile alert systems, prioritizing staff training on legal and technical skills, and optimizing equipment workflows. Future studies should validate these findings in multicenter trials and assess long-term cost-effectiveness.
本研究评估基于海因里希法则的手术室护理安全管理模式的临床价值。
在长征医院进行了一项带有历史对照组的准实验设计。通过便利抽样招募了240例手术患者（干预前：n = 120，2021年12月至2022年；干预后：n = 120，2023年1月至12月）。干预措施包括标准化规程、移动护理系统、电子标本标签和设备管理。使用χ²检验（不良事件）、独立t检验（护理能力得分）和逻辑回归（风险因素）分析定量结果。通过经过验证的自我报告问卷评估患者满意度。
结果显示，实施基于海因里希法则的手术室护理安全管理模式后，手术室护理安全事故发生率显著降低，护理人员在专科护理、标本识别与管理、健康教育、安全意识和操作技能方面有显著改善（P < 0.05）。手术室实施的管理模式对护理安全有积极影响，患者满意度显著提高证明了这一点（P < 0.05）。逻辑多因素回归分析确定了影响手术室护理安全的几个关键因素，包括护理人员的业务能力、法律意识、手术室环境和管理制度。
基于海因里希法则的模式通过减少差错、提高护理能力和提高患者满意度，有效增强了围手术期安全性。临床上，我们建议将标准化规程与移动警报系统相结合，优先对员工进行法律和技术技能培训，并优化设备工作流程。未来的研究应在多中心试验中验证这些发现，并评估长期成本效益。
