基于4R危机理论的管理模式在血站采血护士职业暴露预防控制中的应用

高佳琪 　马延霄

[关键词] 4R危机理论;血站;职业暴露;职业认同感

[中图分类号] R197.6          [文献标识码] C          [文章编号] 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

隨着目前我国输血医学的发展及整体医疗水平的不断提高，临床治疗中用血量逐年增加，已成为各科疾病治疗的有效手段，然而人体血液是目前尚无可取代的一种特殊医疗资源，血站的无偿献血者是其唯一的来源[1-2]。血站的血液采集和成分血的制备和分析均由血站专业护士来完成，血站工作也具有专科性强、技术难度大、风险高的特点，在血液采集或实验过程中，由于血站专业护士需要与患者密切接触，因此可能暴露于潜伏的、不明的经血传播病原体，环境中还会存在其他感染因子，如化学毒药、生物因子、医用仪器等，同时还会有一定的概率发生不测事件带来伤害，所以做好血站护士的职业暴露预防至关重要[3-5]。4R危机管理是将分段式实施步骤与管理体系联系起来，能够持续使采血的每个阶段都能达到有效管理并做到有序实施，因此采用该方法可以减少发生护理风险的概率[6-9]。本研究将4R危机理论应于血站采血护士职业暴露的预防控制中，了解采血护士职业暴露的概况，并提出合理方法以改善目前所存在的问题，得到较好的结果，现报道如下。