“结构-过程-结果”三维质量评价模式在外科住院患者VTE防治工作中的应用  

Application of“Structure-process-result”Threedimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients

作　　者：杨瑛[1] 黎仁兰 宋磊 庄冬梅 范培宇 李思 YANG Ying;LI Renlan;SONG Lei;ZHUANG Dongmei;FAN Peiyu;LI Si(Second Department of General Surgery,Yan’an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院普外二科,云南昆明650051

出　　处：《昆明医科大学学报》2023年第6期169-174,共6页Journal of Kunming Medical University

基　　金：昆明市卫生健康委员会卫生科研课题(2022-14-02-001)。

摘　　要：目的探讨“结构-过程-结果”三维质量评价模式在外科住院患者VTE防治工作的应用效果。方法将2020年7月至2021年6月入住昆明市延安医院普外二科病房400例患者为研究对象,按照随机数字表法分为对照组200例,实验组200例,对照组按医院规定流程进行院内VTE防治护理。实验组将“结构-过程-结果”三维质量评价模式应用于院内VTE防治和管理体系,从结构、过程、结果3个维度进行优化,比较2组的VTE发生率、患者满意度、患者服务感知及护士护理质量得分情况。结果实验组VTE发生率显著小于对照组(χ^(2)=4.592,P<0.05),实验组与对照组在患者满意度(t=-8.811.91,P<0.001)和服务感知(t=-11.813,P<0.001)上差异有统计学意义,其中实验组和对照组在服务感知的5个维度上,服务体系(t=-7.401,P<0.001)、护理专业性(t=-8.347,P<0.001)、执行能力(t=-5.73,P<0.001)、需求反馈(t=-8.024,P<0.001)、护患关系(t=-9.799,P<0.001)均存在差异。实验组在患者满意度和服务感知上的得分显著高于对照组。并且实验组护士护理质量差异有统计学意义,护士护理质量SD分数逐渐降低,护理质量逐渐趋于稳定。结论应用“结构-过程-结果”三维质量评价模式可降低外科住院患者VTE发生率,促进护理团队高质量发展。Objective To explore the application effect of“structure-process-outcome”threedimensional quality evaluation model in the prevention and treatment of surgical inpatients with VTE.Methods A total of 400 patients admitted to Department of General Surgery in Yan’an Hospital of Kunming City from July 2020 to June 2021 were selected as research subjects,and were divided into control group and experimental group using random number table method,with 200 patients in each group.The control group received hospital VTE prevention and treatment nursing following the hospital regulations.The experimental group received the“structure-processresult”three-dimensional quality evaluation model,which was applied to the prevention and management system of VTE in the hospital,and was optimized from three dimensions:structure,process and result.The incidence of VTE,patient satisfaction,patient service perception and nursing quality score of the two groups were compared.Results The incidence of VTE in the experimental group was significantly lower than that in the control group(χ^(2)=4.592,P<0.05).There were significant differences in patient satisfaction(t=-8.811.91,P<0.001)and service perception(t=-11.813,P<0.001)between experimental group and control group.There were differences in five dimensions of service perception between the experimental group and the control group,namely,service system(t=-7.401,P<0.001),nursing professionalism(t=-8.347,P<0.001),executive ability(t=-5.73,P<0.001),demand feedback(t=-8.024,P<0.001),nurse-patient relationship(t=-9.799,P<0.001).The experimental group scored significantly higher on patient satisfaction and service perception than the control group.In addition,the nursing quality of the experimental group showed statistically significant differences,SD scores of nursing quality gradually decreased,and nursing quality gradually stabilized.Conclusion The application of the“structure-process-result”three-dimensional quality evaluation model can reduce the incidence of VTE in surgical in

关 键 词：质量评价体系 静脉血栓栓塞症 VTE防治 

分 类 号：R543.6[医药卫生—心血管疾病]