PDCA在降低DSA术后穿刺处皮肤并发症发生率中的应用  

Application of PDCA in Reducing the Incidence of Skin Complications at the Puncture Site After DSA

作　　者：陈彩虹[1] 赵易波 林慧燕 杨婉丽 苏雅靖 CHEN Caihong;ZHAO Yibo;LIN Huiyan;YANG Wanli;SU Yajing(Department of Neurology,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院神经内科,福建厦门361003

出　　处：《中国卫生标准管理》2022年第11期195-198,共4页China Health Standard Management

摘　　要：目的探讨应用PDCA循环的质量管理降低数字减影血管造影术(digital subtraction angiography,DSA)术后穿刺处皮肤并发症,减轻患者痛苦,提高护理质量。方法选取2020年4—8月在神经内科行DSA术的73例患者,根据改进时间进行分组,4—5月改进前病例36例,6—8月改进后的病例37例,改进前采用常规的DSA术后护理,2020年6—8月应用PDCA中的计划、实施、检查、处理4个步骤对导致DSA术后穿刺处皮肤并发症的原因进行分析,找出真因,制定改进措施,并组织实施,检查计划实施的结果,比较应用PDCA前后DSA术后穿刺处皮肤并发症发生率。结果应用PDCA循环模式的质量管理后,患者导管鞘留置时间和压迫器使用时间比较差异有统计学意义(P<0.01),改进后患者导管鞘留置时间和压迫器使用时间小于改进前;DSA术后穿刺处皮肤并发症发生率由58.33%下降至18.92%,降低了39.41%,差异有统计学意义(P<0.01)。结论运用PDCA循环模式的质量管理对降低DSA术后穿刺处皮肤并发症发生率是行之有效的,减轻患者痛苦,提高护理质量。Objective To explore the application of the quality management of PDCA cycle to reduce the skin complications at the puncture site after digital subtraction angiography(DSA),relieve the pain of patients and improve the quality of nursing.Methods A total of 73 patients who underwent DSA in the neurology department from April to August 2020 were selected and grouped according to the improvement time.There were 36 cases before improvement from April to May,and 37 cases after improvement from June to August.Before the improvement,routine post-operative DSA care was used.From June to August 2020,the four steps of planning,implementation,inspection,and treatment in PDCA were used to analyze the causes of skin complications at the puncture site after DSA,and to find out the true cause.The improvement measures were formulated and implemented,the results of the implementation of the plan were checked,and the incidence of skin complications at the puncture site after DSA was compared before and after the application of PDCA.Results After applying the quality management of PDCA cycle mode,there was a statistically significant difference between the indwelling time of the catheter sheath and the use time of the compressor(P<0.01).After the improvement,the indwelling time of the catheter sheath and the use of the compression device were shorter than those before the improvement;the incidence of skin complications at the puncture site after DSA decreased from 58.33%to 18.92%,a decrease of 39.41%,and the difference was statistically significant(P<0.01).Conclusion Applying PDCA circulation pattern of quality management program is effective to reduce the skin complications at the puncture site after DSA,alleviate the pain of patients and improve the quality of nursing.

关 键 词：PDCA循环 降低 DSA手术 皮肤 并发症 应用 

分 类 号：R197[医药卫生—卫生事业管理]