基于PDCA循环护理模式预防ICU危重患者并发下肢深静脉血栓形成的研究  

Application of PDCA-based cycle nursing model in prevention of deep venous thrombosis of lower extremity in critically ill patients in intensive care unit

作　　者：唐景洁[1] 王密芳[1] 何小玲[1] 汤鲁明[1] Tang Jingjie;Wang Mifang;He Xiaoling;Tang Luming(Intensive Care Unit,Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第二医院ICU,浙江温州325000

出　　处：《中国中西医结合急救杂志》2022年第4期462-465,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：温州市基础性医疗卫生科技项目(Y20210545)。

摘　　要：目的分析基于PDCA循环护理模式预防重症监护病房(ICU)危重患者并发下肢深静脉血栓形成(DVT)的应用效果,为护理干预对策的制定提供理论参考。方法选择2021年1月至2022年3月温州医科大学附属第二医院ICU危重症患者152例作为研究对象,根据护理方式不同分对照组和观察组。对照组采用常规护理;观察组在常规护理基础上接受基于PDCA循环护理;评估两组患者的一般资料、DVT认知评分、一般自我效能感量表(GSES)评分;对比两组患者下肢DVT发生率、医嘱依从性及其对护理的满意度。结果观察组患者对血栓概念、发病原因、疾病危害、健康信念、预防措施的认知评分均高于对照组〔血栓概念(分):18.22±1.64比11.19±1.58,发病原因(分):17.25±1.78比12.07±1.43,疾病危害(分):18.25±1.72比10.65±1.44,健康信念(分):17.98±1.68比12.37±1.56,预防措施(分):18.55±1.24比10.77±1.47,均P<0.05〕。护理干预后,两组GSES评分均明显高于护理干预前,且观察组GSES评分明显高于对照组(分:35.42±3.89比28.53±3.41,P<0.05)。观察组医嘱依从率明显高于对照组〔97.37%(74/76)比77.63%(59/76),P<0.05〕,患者对ICU护理的满意度也明显高于对照组〔98.68%(75/76)比80.26%(61/76),P<0.05〕,而且患者下肢DVT发生率也明显低于对照组〔5.26%(4/76)比23.68%(18/76),P<0.05〕。结论基于PDCA循环护理方法能够显著降低ICU危重患者并发下肢DVT风险,提高ICU患者对下肢DVT的认知度与自我效能感,进而提升其对ICU护理满意度和依从性。Objective To analyze the application effect of plan-do-check-act(PDCA)-based cycle nursing in the prevention of the occurrence of deep vein thrombosis(DVT)of lower extremity in critically ill patients in intensive care unit(ICU),and to provide theoretical reference for the formulation of nursing intervention strategies.Methods A total of 152 critically ill patients in the ICU of the Second Affiliated Hospital of Wenzhou Medical University from January 2021 to March 2022 were selected as the research objects,and they were divided into a control group and an observation group according to difference in nursing methods.The control group received routine nursing,and the observation group received PDCA cycle-based nursing on the basis of routine nursing.The general information,DVT cognition and general self-efficacy scale-schwarzer(GSES)scores of the two groups were evaluated;the incidence of DVT of lower extremity,compliance and their satisfaction with nursing were compared between the two groups.Results The cognitive scores of the patients in the observation group in regard of the concept of thrombosis,the cause of disease,disease hazards,health beliefs and preventive measures were all higher than those in the control group[the concept of thrombosis(score):18.22±1.64 vs.11.19±1.58,the cause of the disease(score):17.25±1.78 vs.12.07±1.43,disease hazard(score):18.25±1.72 vs.10.65±1.44,health beliefs(score):17.98±1.68 vs.12.37±1.56,preventive measures(score):18.55±1.24 vs.10.77±1.47,all P<0.05].After the nursing intervention,GSES scores of the two groups were higher than those before the nursing intervention,and the GSES score of the observation group was significantly higher than that of the control group(score:35.42±3.89 vs.28.53±3.41,P<0.05).The compliance rate of the observation group was significantly higher than that of the control group[97.37%(74/76)vs.77.63%(59/76),P<0.05],and the patients in the observation group were significantly more satisfied with ICU nursing than that in the control group[98.6

关 键 词：PDCA循环护理 重症监护病房 危重症 下肢深静脉血栓 自我效能 满意度 

分 类 号：R47[医药卫生—护理学]