全面质量管理法护理模式在肝胆管结石患者围术期的应用  

The Application of Total Quality Management Method Nursing Model in the Perioperative Period of Patients With Hepatobiliary Tract Stones

作　　者：李雯婷[1] 陈秋霞[1] 张志霞 肖艳玲[1] 胡萍 何芳[3] LI Wenting;CHEN Qiuxia;ZHANG Zhixia;XIAO Yanling;HUPing;HE Fang(Department of Nursing,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei 430064,China;Department of Anesthesiology,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei 430064,China;Department of Hepatobiliary and Pancreatic Surgery,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei 430064,China)

机构地区：[1]武汉科技大学附属天佑医院护理部,湖北武汉430064 [2]武汉科技大学附属天佑医院麻醉科,湖北武汉430064 [3]武汉科技大学附属天佑医院肝胆胰、胃肠外科,湖北武汉430064

出　　处：《中国卫生标准管理》2023年第10期167-171,共5页China Health Standard Management

摘　　要：目的研究全面质量管理法(total quality management,TQM)护理模式在肝胆管结石患者围术期中的应用效果。方法选择2020年1月—2022年2月于武汉科技大学附属天佑医院接受肝胆管结石手术治疗的598例患者作为研究对象,采用随机数字表法分为试验组(n=299)与对照组(n=299)。对照组采用常规围术期护理模式,试验组采用TQM护理模式。比较两组手术相关指标、术后疼痛程度及护理质量评分。结果试验组术后排气时间、排便时间、下床时间及住院时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。试验组术后12、24、72 h的视觉模拟评分法(visual analogue scale,VAS)评分低于对照组,差异有统计学意义(P<0.05)。试验组的护理行政管理、护理质量管理、患者安全管理、患者满意程度评分及总分均高于对照组,差异有统计学意义(P<0.05)。结论全面质量管理法护理模式在肝胆管结石患者围术期的应用能有效提高医院护理质量,对优化患者手术时间指标、降低患者术后并发症发生率、减轻患者术后疼痛程度均有积极作用,值得临床推广。Objective To study the effectiveness of the total quality management(TQM)nursing model in the perioperative period of patients with hepatobiliary stones.Methods A total of 598 patients who underwent surgical treatment for hepatobiliary stones at Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2020 to February 2022 were selected as study subjects and randomly divided into experimental group(n=299)and control group(n=299).The control group used the conventional perioperative care model,and the experimental group used the TQM care model.The surgery-related indexes,postoperative pain level and quality of care scores were compared between the two groups.Results The postoperative time to exhaustion,time to defecation,time to bed and hospital stay were shorter in the test group than in the control group,and the complication rate was lower than in the control group,and the difference was statistically significant(P<0.05);the visual analog scoring method(VAS)scores at 12 h,24 h and 72 h after surgery were lower in the test group than in the control group,and the difference was statistically significant(P<0.05).The nursing administration,nursing quality management,patient safety management,patient satisfaction scores and total scores of the test group were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of the total quality management method nursing model in the perioperative period of patients with hepatobiliary stones can effectively improve the quality of hospital care,and has a positive effect on optimizing the index of patients'operation time,reducing the incidence of patients'postoperative complications and alleviating the degree of patients'postoperative pain,which is worthy of clinical promotion.

关 键 词：肝胆管结石 围术期 全面质量管理法 护理模式 护理质量 疼痛程度 

分 类 号：R473[医药卫生—护理学]