PDCA循环在降低非产科因素全麻剖宫产新生儿窒息率中的应用  

Application of PDCA cycle in reducing rate of neonatal asphyxia in caesarean section under general anesthesia for non-obstetric factors

作　　者：邓恋[1] 宋匀韵[1] 方良欣[1] 胡祖荣[1] DENG Lian;SONG Yunyun;FANG Liangxin;HU Zurong(Department of Anesthesiology,Guangdong Maternal and Child Health Care Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院麻醉科

出　　处：《麻醉安全与质控》2019年第3期155-160,共6页Perioperative Safety and Quality Assurance

基　　金：广东省医学科学技术研究基金项目(A2017478)

摘　　要：目的 通过PDCA循环管理,提高产科麻醉质量,降低新生儿窒息率,保障母婴安全。方法 选取广东省妇幼保健院2017-04/2018-04期间完成的74例非产科因素气管插管全麻剖宫产作为研究对象,通过脑力震荡法,选择降低非产科因素全麻剖宫产新生儿窒息率作为主题研究。对其中新生儿1 min Apgar评分<4分的8例病例进行原因分析、要因分析、真因分析,制定对策方案,实时进行检查、总结、论证并制定标准化流程,指导临床麻醉方案。结果 与改善前相比,改善后的新生儿中重度窒息发生率由62.5%下降到7.6%,麻醉安全质量得到提高。结论 PDCA循环管理模式可明显降低非产科因素全麻剖宫产新生儿窒息率。Objective To improve the quality of obstetric anesthesia, reduce the rate of neonatal asphyxia and ensure the safety of mothers and infants through PDCA cycle management. Methods Seventy-four cases of cesarean section having endotracheal intubation under general anesthesia for non-obstetric factors, completed in Guangdong Maternal and Child Health Care Hospital from April 2017 to April 2018, were selected. Through brainstorming, reducing the rate of neonatal asphyxia in caesarean section under general anesthesia for non-obstetric factors was selected as the subject. Among them, 8 cases with 1-minute Apgar score lower than 4 were analyzed from eight aspects, including cause analysis, true cause analysis, formulation of countermeasures, real-time examination, summary, demonstration and formulation of standardized procedures to guide clinical anesthesia programs. Results The incidence of moderate and severe asphyxia in neonates decreased from 62.5% to 7.6% after the improvement, and the safety and quality of anesthesia were improved. Conclusion PDCA cycle management model can significantly reduce the rate of neonatal asphyxia in cesarean section under general anesthesia.

关 键 词：PDCA循环 新生儿窒息 麻醉质量控制 

分 类 号：R719.8[医药卫生—妇产科学]