基于PDCA循环的麻醉恢复室护理交接班持续质量改进  

Using PDCA cycle to continuously improve the quality of nursing shift work in the post-anesthesia care unit

作　　者：章文军 章明阳[1] 罗小平 舒惠萍 刘闪闪 颜碧莲[2] ZHANG Wenjun;ZHANG Mingyang;LUO Xiaoping;SHU Huiping;LIU Shanshan;YAN Bilian(Department of Anesthesia,Zhongshan People's Hospital,Zhongshan,Guangdong,528403;Department of General Surgery,Zhongshan People's Hospital,Zhongshan,Guangdong,528403)

机构地区：[1]中山大学附属中山医院广东省中山市人民医院手术麻醉科,广东中山528403 [2]中山大学附属中山医院广东省中山市人民医院普外科,广东中山528403

出　　处：《中西医结合护理（中英文）》2019年第3期195-198,共4页Journal of Clinical Nursing in Practice

基　　金：中山市卫生和计划生育局医学科研项目(2017A020413)

摘　　要：目的探讨基于PDCA循环的持续质量改进在提高麻醉恢复室护理交接班质量中的应用效果。方法运用PDCA循环管理法分析麻醉恢复室护士交接班中存在的问题,制定对策并实施改进措施。记录PDCA循环管理法实施后(2017年10月—2018年10月)护理风险事件发生情况,并与PDCA循环管理法实施前(2016年9月—2017年9月)比较。采用自制量表分别调查护士与手术患者对护理交接班质量的满意程度。结果实施前后分别纳入300例患者,实施后护理交接班中患者低体温、非计划性拔管、压力性损伤的发生率均较实施前降低(P<0.05)。PDCA循环管理法实施后,手术患者对护理交接班各维度的满意度评分均高于实施前(P<0.01)。30例护士参与调查,PDCA循环管理法实施后护士对护理交接班各维度的满意度评分均高于实施前(P<0.05)。结论将PDCA循环管理是一种可行的、高效的管理工具,能提高麻醉恢复室护理交接班质量。Objective To evaluate the plan-do-check-act (PDCA) cycle in continuous quality improvement of nursing shift work in the post-anesthesia care unit.Methods The PDCA cycle-based management was adopted to figure out the potential risks in nursing shift work in the post-anesthesia care unit,and targeted measures were carried for the continuous quality improvement.The incidence of nursing adverse events before implementation of PDCA cycle ( n =300,September 2016-September 2017) and after implementation of PDCA cycle ( n =300,October 2017-October 2018) was compared.The satisfactory degree of nurses and surgical patients with nursing shift work were evaluated by self-made questionnaires respectively.Results The incidence rates of hypothermia,unplanned catheter withdrawal and pressure injury were lower after implementation of PDCA cycle compared with those before implementation of PDCA cycle (P<0.05).There was increased score in each dimension of satisfactory degree assessment among patients after implementation of PDCA cycle(P<0.01).Totally 30 nurses were investigated,and the satisfactory degree with nursing shift work were improved after implementation of PDCA cycle (P<0.05).Conclusion The PDCA cycle is a feasible and effective management tool in continuous quality improvement of nursing shift work in the post-anesthesia care unit.

关 键 词：麻醉 麻醉恢复期 低体温 非计划性拔管 压力性损伤 护理管理 护理交接班 

分 类 号：R192.6[医药卫生—卫生事业管理]