持续质量改进方法在COPD患者呼吸功能锻炼中的应用  

Application of continuous quality improvement method in respiratory functional exercise in patients with COPD

作　　者：杨在英[1] 朱金君 洪丹霞[1] 

机构地区：[1]浙江省嘉兴市第二医院呼吸科,314000

出　　处：《中华现代护理杂志》2014年第8期908-910,共3页Chinese Journal of Modern Nursing

摘　　要：目的通过持续质量改进措施（CQI）提高COPD患者呼吸功能锻炼的依从性。方法对实施CQI前护士对COPD患者健康宣教的现状进行分析，找出存在的问题，确定改进目标，制订COPD患者呼吸功能锻炼的护理对策并实施，比较改进前后护士对COPD患者的健康宣教率、床边操作示范落实率、患者对呼吸功能锻炼的依从性，评价改进效果。结果CQI改进前后护士对患者的健康宣教率由59．3％提高到100．0％，床边操作示范落实率由56．1％提高到98．5％，改进前后比较差异有统计学意义（χ^2值分别为125．22，124．82；P〈0．01）；患者对呼吸功能锻炼的依从性明显提高，缩唇呼吸由43．2％提高到100．0％，腹式呼吸由35．1％提高到95．0％，呼吸操由4．6％提高到35．0％，改进前后比较差异有统计学意义（χ^2值分别为193．99，192．14，71．61；P〈0．01）。结论遵循CQI原则有助于实现护理质量的优效管理，提高COPD患者呼吸功能锻炼的依从性。Objective To improve the compliance of respiratory functional exercise in patients with COPD by continuous quality improvement （CQI）. Methods The status of health education before CQI was analyzed, problems were identified, objective of improvement was determined, nursing countermeasures for respiratory functional exercise were formulated and implemented. The rate of health education, implementation of the bedside demo and compliance of respiratory functional exercise were compared before and after improvement, and the effect was evaluated. Results The rate health education increased from 59. 3% to 100% after CQI, the rate of bedside demo implementation improved from 56. 1% to 98. 5%, and the differences were statistically significant （ χ^2 = 125.22, 124. 82, respectively; P 〈 0. 01 ）. The compliance of respiratory functional exercise also improved. The lip breathing promoted from 43.2% to 100%, the abdominal breathing promoted from 35.1% to 95%, the breathing exercises promoted from 4. 6% to 35% , and the differences were statistically significant （ χ^2 = 193.99,192. 14,71.61, respectively; P 〈 0. 01 ）. Conclusions Following the principles of CQI is helpful to realize the effective management of nursing quality and improve the compliance of respiratory functional exercise in COPD patients.

关 键 词：持续质量改进 COPD 呼吸功能锻炼 依从性 

分 类 号：R473.5[医药卫生—护理学]