糖尿病肾病患者血液透析中低血糖管理的持续质量改进  

Application of FOCUS-PDCA model in hypoglycemia management during hemodialysis in patients with diabetic nephropathy

作　　者：柴剑丽 吴春燕[1] 王文娟[1] 应迎娟[1] 蒋欣欣[1] 熊晓玲[1] 

机构地区：[1]杭州市浙江大学医学院附属邵逸夫医院下沙院区血透室,310016

出　　处：《中华护理杂志》2015年第2期170-174,共5页Chinese Journal of Nursing

摘　　要：目的探讨持续质量改进模式在糖尿病肾病患者血液透析中低血糖管理中的应用效果。方法将97例血液透析糖尿病肾病患者分为实验组(49例)和对照组(48例),实验组采用持续质量改进模式进行低血糖管理,实行血液透析前减停胰岛素,血液透析中提前推注50%葡萄糖注射液,嘱患者适当进食,加强血糖监测及健康宣教等新流程,对照组则按原有流程防治低血糖。结果运用持续质量改进模式管理,实验组低血糖发生率明显低于对照组,差异有统计学意义(P<0.01),同时未发生因低血糖引起的意外事件。结论持续质量改进模式在糖尿病肾病患者血液透析中低血糖的管理中发挥了积极作用,降低了透析中低血糖的发生率。Objective To evaluate the effect of FOCUS-PDCA model in hypoglyeenfia management during hemodialysis in patients with diabetic nephropathy. Methods Totally 97 patients with diabetic nephropathy were divided into two groups. Patients in the control group received traditional hypoglycemia management,while FOCUS- PDCA model was implemented in the experimental group in hypoglycemia management,including reducing insulin dosage before hemodialysis,injecting 50% glucose and taking hyperglycemia food during hemodialysis,enhaneing the monitoring of blood glucose and heahh education. Results The frequency of hypoglycemia in the experimental group was significantly lower than that in the control group（P〈0.01）,and no hypoglycemia-induced accident event occulted. Conclusion The application of FOCUS-PDCA model in the hypoglycemia management of patients with diabetic nephropathy can reduced the incidence of hypoglycemia during hemodialysis. It deserves to be widely used in clinical practice to improve the patients＇ quality of life.

关 键 词：FOCUS-PDCA模式 糖尿病肾病 血液透析 低血糖症 

分 类 号：R473.5[医药卫生—护理学]