基于4R危機理論的管理模式在血站采血護士職業(yè)暴露預防控制中的應用

高佳琪 　馬延霄

[關鍵詞] 4R危機理論;血站;職業(yè)暴露;職業(yè)認同感

[中圖分類號] R197.6? ? ? ? ? [文獻標識碼] C? ? ? ? ? [文章編號] 1673-9701（2021）21-0001-04

Application of management mode based on 4R crisis theory in occupational exposure prevention and control of blood collection nurses in blood stations

GAO Jiaqi? ?MA Yanxiao

Jiamusi Blood Center in Heilongjiang Province， Jiamusi? ?154002， China

[Abstract] Objective To explore the application effect of management mode based on 4R crisis theory in occupational exposure prevention and control of blood collection nurses in blood stations. Methods A total of 36 blood station nurses in Jiamusi Blood Center from July 2018 to December 2019 were selected as the research subjects. The routine occupational protection management plan was provided from July to December 2018. The management mode based on the 4R crisis theory was implemented from July to December 2019.The cognitive ability of occupational exposure， occupational identity， and occupational risk behavior of nurses before and after intervention were compared. Results The cognitive ability of occupational exposure of nurses after the intervention was higher than that before the intervention， among which the differences in the environmental risk[（17.0±2.7）points vs. （16.5±2.3 ）points]，accident risk[（22.9±2.4）points vs. （18.8±2.5 points）]， biological risk[（16.9±2.1）points vs. （15.1±2.8） points]， chemical risk [（19.2±2.6）points vs. （17.2±2.3 ）points] and physical risk[（16.8±2.8）points vs. （14.4±2.3）points] were statistically significant（P<0.05）. Professional identity after the intervention was significantly higher than that before the intervention， and occupational risk behavior of nurses after the intervention（5.55%） was significantly lower than that before the intervention（25.0%）， with statistical significance （P<0.05）. Conclusion The application of management mode based on the 4R crisis theory in occupational exposure prevention and control in blood stations can effectively improve the cognitive ability and professional identity of nurses， and reduce occupational risk behaviors， which is worthy of clinical promotion.

[Key words] 4R crisis theory; Blood stations; Occupational exposure; Professional identity

隨著目前我國輸血醫(yī)學的發(fā)展及整體醫(yī)療水平的不斷提高，臨床治療中用血量逐年增加，已成為各科疾病治療的有效手段，然而人體血液是目前尚無可取代的一種特殊醫(yī)療資源，血站的無償獻血者是其唯一的來源[1-2]。血站的血液采集和成分血的制備和分析均由血站專業(yè)護士來完成，血站工作也具有專科性強、技術難度大、風險高的特點，在血液采集或實驗過程中，由于血站專業(yè)護士需要與患者密切接觸，因此可能暴露于潛伏的、不明的經(jīng)血傳播病原體，環(huán)境中還會存在其他感染因子，如化學毒藥、生物因子、醫(yī)用儀器等，同時還會有一定的概率發(fā)生不測事件帶來傷害，所以做好血站護士的職業(yè)暴露預防至關重要[3-5]。4R危機管理是將分段式實施步驟與管理體系聯(lián)系起來，能夠持續(xù)使采血的每個階段都能達到有效管理并做到有序實施，因此采用該方法可以減少發(fā)生護理風險的概率[6-9]。本研究將4R危機理論應于血站采血護士職業(yè)暴露的預防控制中，了解采血護士職業(yè)暴露的概況，并提出合理方法以改善目前所存在的問題，得到較好的結果，現(xiàn)報道如下。