戴明循环在手术设备管理中的应用  

Application of Deming cycle in management of surgical equipment

作　　者：梁丽春 陈佩君 郭履平[1] 刘洋[1] 叶艳霞 陈国民 邵兵[1] LIANG Li-chun;CHEN Pei-jun;GUO Lv-ping;LIU Yang;YE Yan-xia;CHEN Guo-min;SHAO Bing(Department of Anesthesiology,Qingyuan People′s Hospital,the Sixth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Qingyuan 511500,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麻醉科,广东清远511500

出　　处：《中国当代医药》2020年第6期189-192,共4页China Modern Medicine

摘　　要：目的探讨戴明循环(PDCA)在手术设备管理中的应用效果。方法分析2018年1~4月传统管理法术中手术设备故障管理现状,对问题进行原因分析,根据Pareto定律绘制鱼骨图确定主要因素,制定计划和目标。2018年5~10月采用PDCA管理手术设备,加强外科医生和手术室护士设备操作规范化培训,制作设备使用流程图,制订考核标准,加强设备使用后维护及检测,检查反馈,持续质量改进。比较PDCA管理前后术中手术设备故障的发生率、目标达成率及不良事件发生率。结果运用PDCA对手术设备进行管理后,有效降低了术中手术设备故障的发生率,达到了改进目标值,达标率为107.91%,进步率为75.15%,保证了患者的手术安全。PDCA实施后的术中设备故障发生率(2.84%)低于实施前(11.43%),差异有统计学意义(χ^2=8.23,P<0.01);PDCA实施后CQI小组成员在团队精神、品管手法运用、沟通协调、专业知识、活动信心及责任荣誉等方面均有正向成长。结论PDCA应用于手术设备故障管理,可有效提高手术患者的手术安全,达到医疗质量持续改进的目的,并且提高圈员的工作能力及积极性。Objective To explore the application effect of Deming cycle(PDCA)in the management of surgical equipment.Methods The current situation of intraoperative fault management of surgical equipment in traditional management method from January to April 2018 were analyzed,and the causes of these problems were also analyzed,and then the fishbone diagrams according to Pareto′s law was drew to determine the main factors,and formulated plans and goals.From May to October 2018,PDCA was used to manage the surgical equipment,so as to strengthen the standardized training of surgeons and operating room nurses on equipment operation,draw flow charts for equipment usage,formulate assessment standards,intensify maintenance and test after equipment use,check the feedback and continuing to improve quality.The incidence of surgical equipment failures,the goal achievement rate,and the incidence of adverse events before and after PDCA management were compared.Results After using PDCA to manage the surgical equipment,the incidence of surgical equipment failures was effectively reduced,and the improvement target value was achieved.The standard rate was 107.91%,and the improvement rate was 75.15%,which ensured the patients′surgical safety.The incidence of intraoperative equipment failure after PDCA implementation(2.84%)was lower than that before PDCA implementation(11.43%),the difference was statistically significant(χ^2=8.23,P<0.01).After PDCA implementation,CQI team members were growing in team spirit,quality control techniques,communication and coordination,professional knowledge,activity confidence,responsibility and honor.Conclusion PDCA applying to the fault management of surgical equipment can effectively increase the surgical safety for patients,achieve continuous improvement of medical quality,and improve the working competence and motivation of circle members.

关 键 词：戴明循环 手术室 护理质量管理 设备管理 

分 类 号：R248.2[医药卫生—中医临床基础]