RCA-PDCA模式对妇科疾病患者宫腔镜、腹腔镜治疗中手术并发症的风险控制作用  

Analysis of the effect of the RCA-PDCA mode on the risk control of surgical complications in hysteroscopic and laparoscopic treatment of gynecological diseases

作　　者：张佳佳 戎丽琴 郭玲 ZHANG Jiajia;RONG Liqin;GUO Ling(Department of Gynecology,Funan County People’s Hospital,Anhui,Funan 236300,China)

机构地区：[1]安徽省阜南县人民医院妇科,236300

出　　处：《河北医药》2024年第1期154-157,共4页Hebei Medical Journal

摘　　要：目的 分析妇科疾病患者宫腔镜、腹腔镜治疗中RCA-PDCA模式应用对手术并发症风险控制作用及术后康复影响。方法 随机抽选2020年8月至2022年12月行宫腔镜或腹腔镜治疗妇科疾病患者79例,术前采用分段随机化分组设置组别后,对照组(n=40)配合常规围手术期护理,研究组(n=39)配合RCA-PDCA模式下围手术期护理。比较患者手术操作指标,术后康复时间,术后疼痛评分变化,手术并发症发生率,护理质量评分,护理服务满意度生活质量、睡眠质量评分差异。结果 与对照组比较,研究组术中失血量、手术时间、术后肛门首次排气时间、卧床时间、住院时间,麻醉苏醒后8 h、24 h、48 h时NRS评分及手术并发症发生率均降低(P<0.05)。与对照组比较,研究组护理质量评分(护理评估、护理预防、护理配合、护理态度)及护理满意度NSNS评分、SF-36评分均升高,PSQI评分下降,(P<0.05)。结论 RCA-PDCA模式下临床护理在妇科疾病患者宫腔镜、腹腔镜治疗的应用,可促进患者康复,积极控制并发症风险,优化临床护理质量。Objective To analyze the effect of the Root Cause Analysis combined with the Plan-Do-Check-Act(RCA-PDCA) mode on the risk control of surgical complications and postoperative rehabilitation in patients treated with hysteroscopic and laparoscopic surgeries for gynecological diseases.Methods A total of 79 patients treated with hysteroscopic or laparoscopic surgeries for gynecological diseases in our hospital from August 2020 to December 2022 were randomly selected.Preoperative segmented randomization was used to allocate patients into the control group(n=40,routine perioperative nursing) and research group(n=39,perioperative nursing guided by the RCA-PDCA mode).Surgical operation indexes,postoperative recovery time,postoperative pain score,surgical complication rate,nursing quality score,nursing service satisfaction,quality of life,and sleep quality score were compared between groups.Results Compared with those of the control group,patients in the research group presented less intraoperative blood loss,shorter operation time,time of first anal exhaust,bed time and length of stay,and lower Numeric Rating Scale(NRS) scores at 8h,24h and 48h after awakening from anesthesia and incidence of complications(P<0.05).Compared with those of the control group,patients in the research group presented significantly higher scores of nursing quality(nursing assessment,nursing prevention,nursing cooperation,nursing attitude),the Newcastle Satisfaction with Nursing Scales(NSNS) and the 36-item Short Form Health Survey(SF-36),but lower Pittsburgh Sleep Quality Index(PSQI)(P<0.05).Conclusion The application of clinical nursing guided by the RCA-PDCA mode in hysteroscopic and laparoscopic treatment of gynecological diseases can promote the recovery of patients,actively control the risk of complications,and optimize the quality of clinical nursing.

关 键 词：根本原因分析 循环质量管理法 宫腔镜 腹腔镜 妇科手术 

分 类 号：R473.71[医药卫生—护理学]