品管圈活动在危重患者护嘱开立中的应用效果  

Application effect of quality control circle activities in preseribing nursing order for critically ill patients

作　　者：罗丹华[1] 黄淑仪 张银艳 李立青 Luo Danhua;Huang Shuyi;Zhang Yinyan;Li Liqing(Department of Nursing,the Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan 511518,China;Critical Care Medicine,the Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan 511518,China)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)护理部,清远511518 [2]广州医科大学附属第六医院(清远市人民医院)重症医学科,清远511518

出　　处：《中华现代护理杂志》2019年第23期2988-2992,共5页Chinese Journal of Modern Nursing

摘　　要：目的探讨品管圈活动对提高危重患者护嘱开立正确率的效果。方法选择广州医科大学附属第六医院ICU、心血管内科(包括CCU)、脑血管疾病专科、呼吸内科共4个科室高级责任护士共21人为研究对象,同时以上述4个科室2018年4月收治的434例危重患者为品管圈活动前组;2018年10月份收治的419例危重患者为品管圈活动后组进行比较分析。比较品管圈活动前后危重患者护嘱开立正确率,基础护理、体位护理合格率,压疮、跌倒或坠床、失禁性皮炎发生率,高级责任护士对评估知识的掌握率及首次护嘱开立所需时间,责任护士对危重患者病情掌握率,品管圈小组成员综合素质得分情况。结果品管圈活动后危重患者护嘱开立正确率、基础护理与体位护理合格率、高级责任护士对评估知识的掌握率、责任护士对危重患者病情掌握率均明显高于活动前,首次护嘱开立所需时间少于活动前,差异均有统计学意义(P<0.01);危重患者的压疮、跌倒或坠床及失禁性皮炎发生率较活动前有所降低,差异无统计学意义(P>0.05);活动后护士的品管手法运用、团队凝聚力、责任感、协调沟通、自信心、质量改善能力均得到提高,活动前后比较差异有统计学意义(P<0.01)。结论应用品管圈管理方法可有效提高危重患者护嘱开立正确率,改善危重患者护理质量,提高护士工作效率及整体素质。Objective To explore the effect of quality control circle activities on improving the correct rate of nursing orders for critically ill patients.Methods A total of 21 senior responsible nurses in ICU,Cardiology Department(CCU),Cerebrovascular Disease Specialty and Respiratory Department of the Sixth Affiliated Hospital of Guangzhou Medical University were selected as the research objects.Meanwhile,434 critically ill patients admitted in the above four departments in April 2018 were selected as the pre-activity group of quality control circle.The 419 critically ill patients admitted in October 2018 were compared and analyzed in the post-qcc group.The correct rate of nursing orders of critically ill patients,the qualified rate of basic nursing,posture nursing,the incidence of pressure sores,falls or falling out of bed,and incontinence related dermatitis,the mastery rate of senior responsible nurses on assessment knowledge and the time required for the first nursing order to be issued,the mastery rate of disease condition of critical patients by responsible nurses,and the comprehensive literacy scores of members of quality control circle team before and after quality control circle activities were compared.Results After QCC activities,the correct rate of nursing orders for critical patients,the qualified rate of basic nursing and postural nursing,the mastery rate of senior responsible nurses'knowledge of assessment and the mastery rate of nurses'conditions for critical patients were significantly higher than those before QCC activities,and the time needed for the first nurses'orders was less than that before QCC activities,with statistical difference(P<0.01).The incidence of pressure ulcers,falls or falling out of bed,and incontinence related dermatitis was lower than that before the activity,with no significantly statistical difference(P>0.05).After the activity,the nurses'abilities of quality control,team cohesion,sense of responsibility,coordination and communication,self-confidence and quality improvement were a

关 键 词：危重病 品管圈 护嘱 开立 护理质量 

分 类 号：R47[医药卫生—护理学]