基于PDCA循环法建立外科监护室VA-ECMO标准化护理流程的效果研究  

A Study of VA-ECMO Standardized Nursing Procedures in the Surgical Intensive Care Unit Based on PDCA Circulation Method

作　　者：李慧 LI Hui(Department of Surgical Care Unit,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]河南省儿童医院,郑州儿童医院外科监护室,河南郑州450000

出　　处：《临床研究》2022年第10期182-185,共4页Clinical Research

摘　　要：目的分析以PDCA循环法为基础建立起外科监护室静脉动脉系统—体外膜肺氧合(VA-ECMO)标准化护理流程的效果。方法选取2017年3月至2022年3月河南省儿童医院郑州儿童医院外科监护室收治采取VA-ECMO的患儿共74例为研究对象,结合随机数字表法分成对照组(常规提供护理)、观察组(以PDCA循环法为基础建立起外科监护室VA-ECMO标准化护理流程)各37例,比较两组人员到位、物品准备、开始抢救、预充管道以及完成置管时间;并发症出现情况;家属对护理工作的满意度。结果观察组人员到位、物品准备、开始抢救、预充管道以及完成置管时间短于对照组,差异有统计学意义(P<0.05)。观察组出血、感染、栓塞、神经功能异常及肾功能不全等并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组家属满意度高于对照组,差异有统计学意义(P<0.05)。结论以PDCA循环法为基础建立起外科监护室VA-ECMO标准化护理流程效果理想,能有效提高VA-ECMO手术操作效率,减少手术时间和并发症出现,提升家属对护理工作的满意度,值得采用。Objective To analyze the clinical effects of PDCA(plan,do,check,action)-based standardized nursing procedures for VA-ECMO(veno-arterial extracorporeal membrane oxygenation)in the surgical intensive care unit.Methods A total of 74 children undergoing VA-ECMO in our surgical intensive care unit from March 2017 to March 2022 were chosen as research subjects.According to random number table,children were assigned to control group(N=37,routine care)and observation group(N=37,PDCA-based standardized nursing procedures for VA-ECMO).The staff assignment,item preparation,starting rescue,tube precharge and insertion time as well as treatment complications and family member’s satisfaction were compared between two groups.Results The staff assignment,item preparation,starting rescue,tube precharge and insertion time in the observation group were significantly shorter than those in the control group(P<0.05);The occurrences of treatment complications like bleeding,infection,embolism,neurological dysfunction and renal insufficiency in the observation group were significantly lower than control group(P<0.05);The family member’s satisfaction in the observation group was significantly higher than control group(P<0.05).Conclusion PDCA-based standardized nursing procedures for VA-ECMO in the surgical intensive care unit can reduce the operation time and complications,improve the surgical efficacy and family member’s satisfaction.It is worthy of application.

关 键 词：PDCA循环法 外科监护室 静脉动脉系统-体外膜肺氧合 标准化护理流程 

分 类 号：R473[医药卫生—护理学]