基于PDCA循环的呼吸机质控闭环的实践  

Exploration and practice of closed loop of ventilator quality control Practice of Closed Loop of Ventilator Quality Control based on PDCA cycle

作　　者：侍伟伟 肖媛泽慧 仲辉[2] SHI Weiwei;XIAO Yuanzehui;ZHONG Hui(Department of Medical Equipment,Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 225000,China;Department of Biomedical Engineering,Northern Jiangsu Peoples Hospital,Yangzhou Jiangsu 225001,China)

机构地区：[1]上海健康医学院附属第六人民医院东院设备处,上海225000 [2]江苏省苏北人民医院医学工程部,江苏扬州225001

出　　处：《中国医疗设备》2020年第4期113-116,148,共5页China Medical Devices

摘　　要：目的在呼吸机质控闭环中应用PDCA循环,形成质量持续改进的模型。在质控闭环过程中,发现并处理呼吸机的质量隐患和管理中存在的问题,从而达到提高呼吸机使用安全质量,降低风险的目的。方法采用统计学方法对53台有创呼吸机气流分析和电气安全质控数据进行分析,使用SPSS 24.0软件对数据进行分析,采用独立样本t检验方法进行比较。对出现问题进一步改进,进入下一个PDCA循环。结果经统计分析得出,呼吸机气流分析检测的合格率达到90.57%,其主要因素是氧浓度偏低、呼出潮气量偏差较大。采用独立样本t检验方法比较得出,不同使用时间的呼吸机的潮气量差异显著(P<0.05),不同品牌、使用时间的呼吸机的吸气压力平台压均有显著差异(P<0.05),有统计学意义;其他参数在品牌和使用时间上均无显著差异(P>0.05),无统计学意义。呼吸机电气安全检测的合格率达到77.36%,其主要因素是保护接地阻抗不达标。结论在呼吸机质控闭环中应用PDCA循环,根据检查阶段得出的结果,总结提出预防性维修维护方案,强化临床培训、巡检频次等方法加强呼吸机质控闭环,保障设备在临床使用中的安全和治疗质量。Objective PDCA cycle is applied in the closed loop of ventilator quality control to form a model of continuous quality improvement.In the closed loop process of quality control,the hidden danger of ventilator quality and management problems are found and dealt with,so as to improve the safety quality of ventilator and reduce the risk.Methods statistical methods were used to analyze the airflow analysis and electrical safety quality control data of 53 invasive ventilators.SPSS 24.0 software was used to analyze the data,and independent sample t-test was used for comparison.Make further improvements and move on to the next PDCA cycle.Results According to the statistical analysis,the qualified rate of ventilator airflow analysis reached 90.57%,and the main factors were the low oxygen concentration and the large deviation of the tidal volume.The independent sample t-test method was used to compare and find that the tidal volume of ventilators with different use time was significantly different(P<0.05),and the inspiratory pressure platform pressure of ventilators with different brands and use time was significantly different(P<0.05),which was statistically significant.Other parameters showed no significant difference in brand and time of use(P>0.05),showing no statistical significance.The qualified rate of gas safety test of respirator reached 77.36%,and the main factor was that the protective grounding impedance was not up to standard.Conclusion PDCA cycle is applied in the closed loop of ventilator quality control.According to the results obtained in the inspection phase,the preventive maintenance program is summarized and put forward,and methods such as strengthening clinical training and inspection frequency are adopted to strengthen the closed loop of ventilator quality control and ensure the safety and treatment quality of the equipment in clinical use.

关 键 词：呼吸机 PDCA循环 质控闭环 气流分析 电气安全 氧浓度 潮气量 

分 类 号：R473.5[医药卫生—护理学]