降低经桡动脉行冠状动脉介入术后患者睡眠障碍发生率的品管圈实践  

Application of quality control circle activities to reduce the incidence rate of sleep disorders in patients after transradial coronary intervention

作　　者：蔡巧珍[1] 屈永生 黄峥[1] 王倩[1] 金歌[1] 邬海燕 郝献芳[1] 高倩[1] CAI Qiaozhen;QU Yongsheng;HUANG Zheng;WANG Qian;JIN Ge;WU Haiyan;HAO Xianfang;GAO Qian(Department of Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,45005;CCU,Fuwai Central China Cardiovascular Hospital,Zhengzhou,Henan,450007)

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450052 [2]阜外华中心血管病医院冠心病监护病房,河南郑州450007

出　　处：《中西医结合护理（中英文）》2018年第9期40-44,共5页Journal of Clinical Nursing in Practice

摘　　要：目的探讨应用品管圈降低经桡动脉行冠状动脉介入治疗(TRI)后患者睡眠障碍发生率的效果。方法成立护理品管圈小组,活动主题确立为"TRI术后患者睡眠障碍发生率",2017年5月—6月为品管圈活动改善前,行TRI的冠心病患者124例,统计124例患者发生睡眠障碍的原因,提出针对性对策并组织实施,制订专科护理质量指标,维持质量改进效果。观察2017年8月—9月品管圈活动改善后164例TRI患者睡眠状况。结果改善前睡眠障碍发生率66. 13%(82/124),品管圈改善重点为术侧肢体肿胀和术侧肢体疼痛,止血阀减压频次不足、不知晓活动方法、消肿止痛措施可操作性差、无监管体系为真因。改善后睡眠障碍发生率为30. 49%(50/164),品管圈活动目标达成率为101. 63%。改善后患者术侧肢体肿胀、疼痛发生率均较改善前减少(P <0. 05)。结论品管圈活动在降低冠心病患者TRI术后睡眠障碍发生率方面效果显著,同时提高了护士循证护理和创新的能力。Objective To investigate the effect of quality control circle （QCC） activities to re- duce the incidence rate of sleep disorders in patients after transradial coronary intervention （TRI）. Methods The QCC group was set up, and the theme of the QCC activity was to reduce the incidence rate of sleep disorders in patients after TRI. Before implementation of QCC activities, 124 patients undergoing TRI between May, 2017 and June, 2017 were included. Corresponding interven- tions were carried out based on the analysis of potential reasons of sleep disorders. A set of nursing quality indexes was established to implement and maintain quality improvement. Another 164 pa- tients with TRI were included between August 2017 and September 2017, and the sleep state of pa- tients were observed and compared before implementation of QCC activities. Results The inci- dence of sleep disorders was 66.13% （82/124） before implementation of QCC activities. The key points of improvement were limb swelling and pain, and the root causes were insufficient frequency of hemostasis, ignorance of activity methods, poor performance in relieving swelling and pain, lack of supervision system. The incidence of sleep disorders dropped to 30. 49% （50/164） after imple- mentation of QCC activities, with a target achievement ratio of 101.63 %. The incidence rate of limb swelling and pain was decreased after implementation of QCC activities compared with that beforeimplementation of QCC activities （P 〈 0.05）. Conclusion The QCC activity is an effective tool to reduce the incidence rate of sleep disorders in patients after TRI. It can also improve the evidencebased nursing ability and creativity of nurses.

关 键 词：品管圈 冠状动脉介入治疗 经桡动脉 睡眠障碍 循证护理 冠状动脉粥样硬化性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病]