集束化护理降低ICU非计划性拔管率的实践  

Practicing for reducing the incidence of unplanned extubation for patients in ICU by cluster nursing

作　　者：袁翠[1] 张建霞[1] 王玉英[1] 邓兰芬[1] 胡美华[1] 贾亚丽[1] 王晓月[1] 高玲玲[1] 

机构地区：[1]北京大学第一医院,北京100034

出　　处：《护士进修杂志》2015年第17期1592-1596,共5页Journal of Nurses Training

摘　　要：目的调查及分析非计划性拔管的发生率及原因,降低非计划性拔管的发生率。方法借用品管圈管理手法,通过分析非计划性拔管发生的原因,制订一系列集束化干预措施,并实施于临床,如减轻胃管刺激方法的培训,改善胃管固定流程,常规评估RASS躁动-镇静评分,制订并填写胃管、气管护理日志;改良约束手套等方法。结果非计划性拔管的发生率由1.72%降低到0.55%。结论集束化干预措施可有效降低ICU的非计划性拔管率;品管圈的管理手法促进了ICU普通护士参与护理质量的持续改进。Objective To investigate and analyze the reasons of the incidence of unplanned extubation （UEX） by studying All patients with indwelling catheter in certain time, and take steps to reduce the incidence of the UEX. Method The quality control circle（QCC） were used for studying and analyzing the reason of UEX. a series of measures was formulated and implemented in clinical care, such as reducing gastric tube stimulation methods of training; improving gastric tube fixed process, regular assessment RASS agitation sedation scores, formulate and fill out the gastric and tracheal tube nursing recording, modifying constraint gloves, etc. Result The incidence of UEX reduced from 1.72% to 0.55% by applying the targeted measures. Conclusion The incidence of UCE can be reduced by implement the effective cluster intervention measures. The participating and continuous improvement of nursing quality for ICU nurses can be achieved be applying QCC management. The unresolved issues should be put in the next quality management circle or PDCA circle.

关 键 词：非计划性拔管 ICU 集束化 品管圈 护理 

分 类 号：R473[医药卫生—护理学]