目标管理在提高初治肺结核患者痰标本留取质量上的价值  

The value of target management in improving the quality of sputum samples retention of initially treated pulmonary tuberculosis patients

作　　者：江华 王琳 汤玲玲 曾先兰 JIANG Hua;WANG Lin;TANG Ling-ling;ZENG Xian-Lan(Department Five of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China)

机构地区：[1]同济大学附属上海市肺科医院结核五病区,200433 [2]同济大学附属上海市肺科医院结核一病区,200433 [3]上海市第二康复医院

出　　处：《中国防痨杂志》2019年第6期676-680,共5页Chinese Journal of Antituberculosis

摘　　要：目的探讨目标管理在初治肺结核患者痰标本留取质量控制中的应用效果。方法收集2017年7—12月在上海市肺科医院结核科因疑似肺结核住院后确诊并接受治疗的338例初治肺结核患者作为研究对象。将入住结核科一病区的173例患者作为对照组,入住结核科五病区的165例患者作为观察组。对照组采取结核科常规护理管理及痰标本留取宣传教育,同时对患者痰标本留取及规范送检等情况进行督导检查;观察组在采取常规护理管理措施的基础上对患者痰标本的留取实施目标管理,即医生、护士和患者共同参与并确定痰标本留取的总目标,并将总目标分解成分目标,通过分目标的设定、目标实施、信息反馈处理、检查实施结果最终达到总目标。对两组患者住院期间痰标本留取的完成情况、合格情况及痰细菌学检测阳性情况进行比较。结果观察组患者住院期间应留取痰标本502份,实际留取476份,合格432份,痰细菌学检测阳性312份;对照组患者住院期间应留取痰标本524份,实际留取431份,合格307份,痰细菌学检测阳性172份。观察组痰标本留取的完成率为94.82%(476/502),合格率为90.76%(432/476),痰细菌学检测阳性率为72.22%(312/432),均明显高于对照组的82.25%(431/524)、71.23%(307/431)、56.03%(172/307),两组比较差异均有统计学意义(χ^2值分别为39.50、57.15、20.83,P值均<0.01)。结论目标管理能提高患者痰标本留取的主动性,提高痰标本留取的质量及痰细菌学检测的阳性率,有利于疑似肺结核患者尽早明确诊断。Objective To explore the application effect of target management in quality control of sputum specimens retention of initially treated pulmonary tuberculosis patients.Methods A total of 338 initially treated pulmonary tuberculosis patients were collected as subjects, who were hospitalized because of suspected tuberculosis and then were diagnosed and accepted the treatment in Tuberculosis Department of Shanghai Pulmonary Hospital from July 2017 to December 2017. They were divided into two groups: the observation group (N=165, patients hospitalized in the Ward 5 of Tuberculosis Department) and the control group (N=173, patients in the Ward 1). The patients in the control group received the routine nursing management in tuberculosis department, and the pro-paganda and education of sputum specimen retention. Meanwhile, sputum specimen retention and the standard inspections were supervised and inspected. In addition to these routine managements, patients in the observation group accepted other target management approaches for the sputum specimen retention, namely doctors, nurses and patients jointly involved and determined the overall target of sputum specimen retention, and decomposed the overall target into sub-targets, and finally reached the overall target by sub-target setting, target implementing, feedback processing, and implementation results checking. The completion rate, qualified rate and positive rate of Mycobacterium smear in sputum samples between the two groups were compared.Results In observation group, 502 sputum specimens were supposed to be retained, and 476 were actually remained, among them 432 were qualified and 312 were positive for Mycobacterium smear. In control group, 524 sputum specimens were supposed to be retained, and 431 were actually remained, among them, 307 were qualified and 172 were positive for Mycobacterium smear. In observation group, the completion rate of retention of sputum specimens was 94.82%(476/502), qualified rate was 90.76%(432/476), and positive rate of Mycobacterium sm

关 键 词：结核 肺 痰 标本制备 诊疗工作管理 医学 对比研究 

分 类 号：R473.5[医药卫生—护理学]