过程决策程序图在脑卒中后神经源性尿失禁女性患者留置尿管中的应用  

Application of process decision program chart in female patients with neurogenic urinary incontinence and indwelling catheter after stroke

作　　者：乔秋阁[1] 李玉敏[2] 唐丽梅[3] 史蕾[4] 刘芳[1] 游道锋[5] 

机构地区：[1]河北医科大学第二医院东院区普通外科,石家庄050038 [2]河北医科大学第二医院康复科,石家庄050038 [3]河北医科大学第二医院神经内科,石家庄050038 [4]河北医科大学第二医院泌尿外科,石家庄050038 [5]河北医科大学第一医院急诊科,石家庄050031

出　　处：《中华现代护理杂志》2016年第30期4394-4399,共6页Chinese Journal of Modern Nursing

摘　　要：目的：研究采用过程决策程序图（ PDPC）的质量控制方法对预防脑卒中后神经源性尿失禁女性患者留置尿管并发症的影响。方法选取脑卒中首次发病后神经源性尿失禁的女性患者94例，将2014年1月—2015年1月未经过PDPC方法干预的48例患者设为对照组，将2015年2月—2016年1月采用PDPC方法系统干预的46例患者设为干预组。对照组患者依照《基础护理学》留置尿管护理要求进行护理，干预组患者依照PDPC活动流程实施护理，比较两组患者留置尿管的相关并发症指标及护士的自我评价指标。结果干预组患者留置尿管相关的尿路感染、尿道损伤等并发症发生比率明显较对照组降低，差异具有统计学意义（ P〈0.05）；PDPC方法应用后护士团队的责任心、工作积极性、自信心等方面的自我评价均较应用前显著提升。结论在脑卒中后神经源性尿失禁留置尿管的女性患者中应用PDPC法，可以减少并发症的发生、有效提升护理质量，同时护理人员的思维也得到了拓展，解决问题的能力得到了提升，自我评价提高。Objective To determine the influences of quality control method of process decision program chart （ PDPC ） on preventing complications related to indwelling catheter in female patients with neurogenic urinary incontinence after stroke. Methods We selected 94 female patients with neurogenic urinary incontinence after the first stroke. A total of 48 patients without accepting PDPC interventions from January 2014 to January 2015 were selected as control group. A total of 46 patients accepting systematic PDPC interventions from February 2015 to January 2016 were selected as intervention group. Patients in control group were provided with nursing care based on the nursing requirements of the indwelling catheter in Basic Nursing Science. Patients in intervention group were provided with nursing care according to the process of PDPC. And then, we compared the catheter related complications of patients between two groups and the self-evaluation of nurses. Results The incidence of complications including urinary tract infection and urethral injury in intervention group was lower than that in control group with a significant difference （ P〈0.05） . After the PDPC method was carried out, the self-evaluation involving responsibility, work enthusiasm, and self-confidence of nurses was significantly improved. Conclusions The application of PDPC in female patients with neurogenic urinary incontinence and indwelling catheter after stroke not only can reduce the incidence of complications, effectively improve nursing quality, but also can expand nurses′ thinking, hoisting their abilities to solve problems and improve their self-evaluations.

关 键 词：卒中 神经源性尿失禁 PDPC法 留置尿管 女性患者 

分 类 号：R473[医药卫生—护理学]