品管圈活动缩短妇产科腹部手术后尿管留置时间的应用效果  

Effect of quality control circle activity on shortening postoperative urinary catheter indwelling time of obstetrics and gynecology department patients undergoing abdominal surgery

作　　者：李玲玲[1] 彭飞[2] 顾春怡[3] 任雪宁 杨秋雨 张群 LI Ling-ling;PENG Fei;GU Chun-yi;REN Xue-ning;YANG Qiu-yu;ZHANG Qun(Shanghai Changzheng Hospital,Shanghai 200003,China;不详)

机构地区：[1]上海长征医院妇产科,上海200003 [2]上海长征医院护理部,上海200003 [3]复旦大学附属妇产科医院护理部,上海200011 [4]上海长征医院疾病预防控制科,上海200003

出　　处：《中华医院感染学杂志》2024年第2期288-293,共6页Chinese Journal of Nosocomiology

基　　金：上海市医院诊疗技术推广及优化管理项目(SHDC22022214)。

摘　　要：目的探讨品管圈活动(QCC)在缩短妇产科腹部手术患者尿管留置时间中的作用,评价降低导尿管相关性尿路感染的效果。方法分别选取海军军医大学第二附属医院妇产科收治的品管圈活动开展前后行腹部手术住院患者为研究对象,其中2020年12月10日—2020年12月30日收治的59例为实施QCC活动前,2021年5月13日—2021年6月2日收治的61例为实施QCC活动后,比较两组患者术后尿管留置时间、导尿管相关性尿路感染(CAUTI)发生情况、术后首次下床时间和术后住院天数。结果实施QCC活动后,腹部手术患者尿管留置时间由(34.84±8.74)h缩短至(21.54±4.92)h,比较差异有统计学意义(P<0.05);QCC活动前,3例患者发生CAUTI,QCC活动后未发生CAUTI;与QCC活动前比较,患者首次下床时间缩短(P<0.05),术后住院天数比较无统计学差异;QCC活动后,圈员的解决问题能力、责任心、沟通协调、自信心、团队凝聚力、积极性、品管手法和和谐度均呈正向提升。结论品管圈活动有效缩短了腹部手术患者的尿管留置时间,缩短了患者术后首次下床时间,整个活动过程增强了医护团队凝聚力,规范了CAUTI医院感染防控流程。OBJECTIVE To explore the effect of quality control circle(QCC)on shortening the urinary catheter in-dwelling time of the obstetrics and gynecology department patients undergoing abdominal surgery and evaluate the effect on reducing the incidence of urinary catheter-associated urinary tract infection.METHODS The patients who were hospitalized and underwent abdominal surgery in the Second Affiliated Hospital of Naval Medical University before and after the QCC activity was carried out were recruited as the research subjects,59 patients who were treated from Dec 10,2020 to Dec 30,2020 were before the QCC activity was carried out,and 61 patients who were treated from May 13,2021 to Jun 2,2021 were after the QCC activity was carried out.The postoperative u-rinary catheter indwelling time,incidence of urinary catheter-associated urinary tract infection(CAUTI),initial off-bed time after surgery and postoperative length of hospital stay were observed and compared between the two groups of patients.RESULTS The urinary catheter indwelling time of the abdominal surgery patients was(21.54±4.92)hours after the QCC activity was carried out,(34.84±8.74)hours before the QCC activity was carried out,and there was significant difference(P<0.05).3 patients had CAUTI before the QCC activity was carried out,while no patient had CAUTI after the QCC activity was carried out.The initial off-bed time of the pa-tients was shorter after the QCC activity was carried out than before the QCC activity was carried out(P<0.05).There was no significant difference in the postoperative length of hospital stay.The ability of solving problem,re-sponsibility,communication and coordination,self-confidence,team cohesion,enthusiasm,quality control tech-niques and harmony of the circle members were positively improved.CONCLUSION The QCC activity can effec-tively shorten the urinary catheter indwelling time and the initial off-bed time,boost the team cohesiveness during the whole process,and standardize the prevention and control procedures of CAUTI.

关 键 词：品管圈 腹部手术 尿管留置时间 导尿管相关性尿路感染 

分 类 号：R713[医药卫生—妇产科学]