随着人们法制观念的不断提高，病人维权意识逐渐增强，对医疗护理提出了更高的要求，因心电监护仪使用不当导致的投诉也逐渐增加。本院2003年6月至2004年6月被投诉4起，2004年7月至2005年6月5起，2005年7月至2006年6月9起；护士巡视不到位、责任心不强、病情变化未及时发现8例，心电监护仪参数设置不当或报警系统不工作5例，对心电监护仪性能不了解影响抢救治疗2例，设备本身问题2例，监护收费问题1例。病人自我保护意识增强与护士服务观念转变相对滞后的矛盾 随着病人及家属法制观念的逐渐加强，对医护质量的要求也越来越高〔1〕。在医疗护理活动中过去根本不会酿成纠纷的问题，现在都可能引发投诉，病家认为花了钱就要得到最好的服务及疗效，稍有不当病人或家属就要“讨个说法”，更有甚者，认为病人进了医院，化了钱，就得治好病，如病情反复或恶化就会千方百计寻找医疗工作中的缺陷和漏洞，进行投诉；而心电监护仪又是摆在他们面前看得见，摸得着的东西，稍有不慎就会成为投诉对象。护理服务质量与病人期望值之间的矛盾 需要心电监护的病人相对病情都比较重，家属特别关注治疗护理情况，以为使用心电监护仪后病情就能得到控制，当病情出现变化时就难以接受；而护士在护理过程中操作稍不仔细，解释不到位，对病人关心与理解不够，没有形成良好的护患关系，也就会受到病人及家属的迁怒。 护理队伍的年轻化，护理人员对心电监护仪性能不熟、使用不到位 当前医院发展速度较快，年轻护士较多，护理队伍的年轻化也已经成为护理投诉的主要原因之一〔2〕。首先年轻护士资历浅，工作经验不足，加之上岗前没有进行系统培训，不同程度地存在对心电监护仪使用性能及设置不熟悉，其次，年轻护士缺乏必要的医患沟通技巧和交谈艺术。心电监护仪故障延误病情 有些心电监护仪由于长时间连续使用，或者使用不当，或者年久失修等各种原因发生故障，特别是一些平时使用心电监护仪很少的科室，医护人员没有定期检查，不能及时发现和处理故障，一旦病情有变化需要时，却未能及时监护而延误了病情的监测、治疗，导致病家投诉。心电监护仪的使用费用相对较高，以每小时计算，且药费、检查费、一次性物品的广泛应用，给病家带来沉重的经济负担，因此，他们对收费特别敏感，对心电监护仪所用时数常有争议，加之新闻媒体过分渲染，对收费不放心，而多数家属在高额的医疗费用支出后疾病仍未明显好转，故将怨气发泄到仪器的使用和收费上导致投诉。为了适应目前新形势下病人对护理服务质量的要求，必须不断强化护士的优质服务意识，牢固树立“以人为本，以病人为中心”的服务观念，尊重病人的合法权益，尽量满足其要求。如在行心电监护前应耐心向病人及家属做好解释宣教工作，介绍心电监护的目的及仪器的安全性，告知可能出现的报警声。在整个监护过程中应加强巡视和观察，注意心电监护仪参数的变化，出现报警声时能迅速做出处理，并及时记录和保存。As the legal concept of continuous improvement， the patient gradually build up their human rights awareness， health care for a higher demand， due to the use of ECG monitor misconduct also led to a gradual increase in Hospital from June 2003 to June 2004 were 4 complaints since July 2004 to June 2005 5， July 2005 to June 2006 9; nurse visits are not in place， do not have a strong sense of responsibility， timely detection of the disease did not change in 8 cases， ECG monitor improper parameter setting alarm system does not work or five cases， the ECG monitor the performance of emergency treatment do not understand the impact of two cases， two cases of the issue of the equipment itself， the issue of guardianship fees and charges in 1 Self-protection awareness of patients and nurses to enhance the concept of service is lagging behind changes in the conflict Patients and their families with the legal concept of the gradual strengthening of the quality of health care have become more sophisticated [1] Activities in health care will not lead to disputes over the issue， now may lead to complaints that the patient and his family will be花了钱the best services and the efficacy， some patients or their family will be inappropriate "to have a say" and， worse， that the patient into the hospital， of the money， you must heal the disease， such as illness or deterioration of repeated medical work will do everything possible to find defects and flaws in the conduct complaints; and ECG monitor is placed in front of them visible and tangible things， a little carelessness will become the target of Quality and patient care services in the conflict between the expectations The need for ECG monitoring of patients is relatively heavier than the disease， their families pay special attention to health care situation， that the use of ECG Monitor can be brought under control after the disease， when a change in condition when it is difficult to accept; and nurses in the care process is not operating slightly careful to explain in place， concern and understanding for patients not enough， there is no good nurse-patient relationship， but also patients and their families will be the Care of the younger teams， nursing staff on ECG monitor the performance of the wake of the use of non-place Faster development of the current hospital， more young nurses， care of the younger team care has become one of the main causes of complaints [2] First of all， the young junior nurses， lack of work experience， coupled with no systematic pre-training， varying degrees of ECG monitor and the setting up of the use of performance are not familiar with， and secondly， the younger the patient the nurses lack the necessary communication skills and conversation ECG monitor the delay fault condition ECG monitor some time as a result of continuous use， or improper use， or repair a variety of reasons such as failure， in particular， a number of normal ECG monitor the use of small sections， medical personnel do not conduct regular inspections， timely detection and to deal with failure， once the necessary conditions have changed， but failed to delay care and monitoring of the condition， treatment， patient and his family led to ECG monitor the use of the relatively high cost per hour basis， and drugs， inspection fees， the widespread application of a one-time items， to the patient and his family a heavy financial burden， so that they are particularly sensitive to charges of heart Monitor electricity used by a number of often controversial when， in addition to the news media exaggerated the charges do not trust， and the majority of families in the high medical costs to be incurred in a marked improvement after the disease has not yet， it will vent their grievances to the use of equipment and fees the lead to In order to adapt to the new situation at present patients quality care， nurses must continue to strengthen the services， and firmly establishing the "people-oriented， patient-centered" concept of service， respect for the legitimate rights and interests of patients， as far as possible to meet their If the line before ECG patience to do a good job to explain the patients and their families and education on the purpose of ECG and the security apparatus， this may sound the In the guardianship process should strengthen the inspection and observation， attention to ECG monitor changes in parameters， sound alarms when there quickly to deal with， and to record and preserve a timely
