院外回访联合品管圈在骨科术后卧床患者的应用效果  

Application analysis of out-of-hospital return visit quality control circle in prevention of DVT formation in patients with orthopedic surgery

作　　者：赵花[1] 焦亚娟[1] 张亚宁[2] 张芳[3] 陈燕妮 ZHAO Hua;JIAO Yajuan;ZHANG Yaning;ZHANG Fang;CHEN Yanni(Department of Orthopedics,Baoji Central Hospital,Baoji 721008,Shanxi,China;Department of Oncology,Baoji Central Hospital,Baoji 721008,Shanxi,China;Baoji Central Hospital,Baoji 721008,Shanxi,China)

机构地区：[1]宝鸡市中心医院骨科,陕西宝鸡721008 [2]宝鸡市中心医院肿瘤外科,陕西宝鸡721008 [3]宝鸡市中心医院骨科,陕西宝鸡721008

出　　处：《西部医学》2019年第9期1461-1464,1469,共5页Medical Journal of West China

基　　金：陕西省科学技术研究发展计划项目(2013K14-02-24)

摘　　要：目的探讨院外回访联合品管圈在骨科术后卧床患者中的应用效果。方法选取我院2017年1月~2018年3月收治的骨科手术患者185例,按入院时间先后顺序不同分为对照组(94例)和观察组(94例)。对照组给予院内常规护理、院外不回访,观察组在此基础上实施院外回访联合品管圈活动,出院前比较两组患者下肢深静脉血栓(DVT)预防行为掌握率、患者满意度、术后各项观察指标(术后排气时间、术后排便时间和不良反应发生率);出院后第3个月,比较患者(按时服药、按时复诊、按时锻炼及健康饮食等方面)依从性情况、术后DVT发生率等情况。结果观察组患者出院前DVT预防行为掌握率和患者满意度均明显高于对照组(P<0.05),且术后各项观察指标也均优于对照组(P<0.05)。出院后第3个月,观察组患者依从性明显优于对照组(P<0.05),且DVT发生率也低于对照组(P<0.05)。结论实施院外回访联合品管圈活动,有利于骨科术后卧床患者掌握DVT预防行为,能有效提高患者DVT预防依从性,促进术后康复,且患者满意度高。Objective To explore the effect of out-of-hospital return visit combined with quality control circle in preventing DVT formation in patients lying in bed after orthopaedic surgery.Methods 91 surgical patients admitted to orthopedics department of our hospital from January to March 2017 (before the implementation of quality control circle) were randomly selected as the control group,and 94 surgical patients admitted to our hospital from January to March 2018 (after the implementation of quality control circle) were selected as the observation group.The control group was given routine nursing in hospital and no return visit outside hospital,while the observation group was given out-of-hospital return visit combined with quality control circle activities on this basis.The lower extremity deep venous thrombosis (DVT) prevention behavior control rate,patient satisfaction,postoperative observation indicators (postoperative exhaust time,postoperative defecation time and incidence of adverse reactions) were compared.Three months after discharge,the compliance and the incidence of DVT were compared among patients (taking medicine on time,re-visiting on time,exercising on time and eating healthily,etc.).Results The rate of preventive behavior and patient satisfaction were significantly higher in patients with DVT before discharge from hospital than in control group ( P <0.05),and the postoperative observation indicators are also better than the control group ( P <0.05).Three months after discharge,the compliance was significantly better in the observation group than that in the control group( P <0.05).The incidence of DVT was also lower than that of the control group( P <0.05).Conclusion The implementation of out-of-hospital visits combined with quality control circle activities is conducive to the prevention of DVT for patients in bed after orthopaedic surgery.It can effectively improve the compliance of patients with DVT prevention and promote the rehabilitation after surgery.

关 键 词：骨科术后卧床患者 院外回访 品管圈 DVT 

分 类 号：R473.6[医药卫生—护理学]