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1、167 例护患纠纷原因分析及对策【摘要】 目的 探讨护患纠纷的原因及预防对策。方法 采用统计学方法对我市 8 年来 67 例护患纠纷原因进行回顾性分析。结果 原因主要包括医疗收费、服务态度、业务素质、法律意识、沟通障碍。结论 加强法制、安全教育，提高服务意识，规范执业行为，改善服务态度，提高服务质量，加强护患沟通是减少护患纠纷的关键。【关键词】 护患纠纷；原因；对策【Abstract】 Objective To analyse causes of nurses-patients conflicts and its preventive countermeasures.Methods Sixty
2、-seven cases of nurses-patients conflicts in 8 years were analysed retrospectively in the city.Results The main causes of nurses-patients conflicts were medical cost,attitude of medical personnel,professional quality,legal consciousness and communicating failure.Conclusion The key of decreasing of n
3、urses-patients conflicts is strengthening law, order and security education, elevating servicing consciousness, regulating professional behavior, improving service attitudes and quality, and strengthening nurses-patients communicating.2【Key words】 nurses-patients conflicts; causes; countermeasuresWi
4、th elevating of living qualities,the health concepts is transformed and self-safety consciousness is strengthened.In this condition,the cases of nurses-patients conflicts are roaring.The patients or their relatives often complaints or take lawsuit,even disturbance medical institutes working place ag
5、ainst medical professionals.This article is to explore how to prevent nurses-patients conflicts and improve relation between patients and medical professionals.We reviewed 67 cases of nurses-patients conflicts occurred from 1998 to 2005 to find ways to resolving the problem.1 Clinical dataIn 1998-20
6、05,67 cases of medical conflicts relating to nursing service among 372 cases of medical conflicts according to municipal health administration statistics.The causes of nurses-patients conflicts were found by analysing primary cases files,identical documents and negotiating 3agreements.2 Statistical
7、resultsIn 67 cases,service problem occurred in 20 cases（29.85%）,medical costs in 15 cases（22.39%）,communicating failure in 13 cases（19.40%）,professional deficiency in 11 cases（16.42%）,operating error in 5 cases（7.46%）,medical facilities in 3 cases（4.48%）.By analysing,17 cases of complaints related t
8、o nursing faults （25.37%）,nursing fault existed in 21 cases（31.34%）,but irrelated to the unsatisfactory results,non-nursing faults in 29 cases（43.28%）. We found that the legal knowledge was insufficient in the nurses.The nursing documents fault or inconsistence with clinical data were in 25 cases（37
9、.31% ）.3 Analysis3.1 Social factor3.1.1 Strengthened legal consciousness and selfprotective behavior The patients considered that they are special 4consumers in the course of medical process,they have the right to know of their health condition,examination,drug administration and medical costs, and
10、have the right to permit what action should be done.If the nurses did not meet the requirements of the patients for their rights,suspicion and disbelieve would occur,the complaints against nurses could hardly be avoided.3.1.2 Increased requests of services A long distance exists between the conditio
11、ns of the nursing and the hope of the patients and their relatives because of medical limitation,medical risks and so on.In the rural area,the medical equipment out of date in the emergency condition can not help the patients further,but the patients do not accept that,the conflicts would be constit
12、uted.3.1.3 Losing credibility from the public For years,medical institutes credibility from the public is losing,minor error can lead to complaints because of the preoccupied view of the patients.And many medical malpractice exposed on the media,the public eyed on the issues of faulty medical treatm
13、ent.The concern and supervision by public opinion 5should be played a role in improving the quality of medical service.But,some reports on the media deviate from the facts for deficiency of medical knowledge or the determination has not been identify by the organ for management of medical conflicts
14、in the early stage of issue.In this case,public opinion provoked and social hot spot shaped,hospital in an awkward situation.When the news workers report or evaluate the issues against objective in the case of medical knowledge deficiency or lacking medical details,they evoke a resounding response.3
15、.1.4 Be difficult to understand medical system in patients With strengthening economic sense of the patients,a bundle of conflicts occurred because of medical costs.The medical costs is the reflection of social economic transformation in the medical market.The nurses are responsible to booking and p
16、ressing patients for payment,the conflicts often occur between nurses and patients first.And the increased costs out of the patients burden with the importation of high technology or application of new drugs.If the payment items filled in error,patients may misunderstand.In this study,the complains for medical costs was 22.39%,91.7% was patients 6pay themselves.And 2 cases resulted in misunderstanding visit rule of the hospital.3.2 Management fault3.2.1 Legal system de
