PDCA在降低患者自行注射预灌式低分子肝素钠皮下瘀斑发生率中的应用效果  

Application Effect of PDCA in Reducing the Incidence of Subcutaneous Ecchymosis of Patients With Self-Injected Pre-Perfusion Low Molecular Weight Heparin Sodium

作　　者：张玉珍[1] 黄艳慧[1] 吴荣锋 ZHANG Yuzhen;HUANG Yanhui;WU Rongfeng(Reproductive Medical Center,Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院妇产科生殖医学中心,福建厦门361003

出　　处：《中国卫生标准管理》2024年第20期189-193,共5页China Health Standard Management

基　　金：厦门市2020年联合支持医疗卫生重点项目(3502Z20209001)。

摘　　要：目的探讨开展计划-实施-检查-处理(plan-do-check-act,PDCA)循环在降低患者自行注射预灌式低分子肝素钠皮下瘀斑发生率中的应用效果。方法将2023年3—5月在厦门大学附属第一医院就诊并自行注射预灌式低分子肝素钠的56例患者作为对照组,将2023年8—10月自行注射预灌式低分子肝素钠的49例患者作为观察组。对照组采用常规注射流程进行注射指导,观察组运用PDCA循环工具进行注射干预管理。比较2组自行注射预灌式低分子肝素钠皮下瘀斑的发生率。结果观察组注射部位未轮换发生率为20.4%,未带空气泡注射发生率为18.4%,按压手法不准确发生率为16.3%,进针深度不准确发生率为6.1%,按压时间不够发生率为4.1%,低于对照组的44.6%、39.3%、35.7%、19.6%、17.9%,差异有统计学意义(P<0.05)。观察组注射时疼痛程度优于对照组,差异有统计学意义(P<0.05)。观察组皮下瘀斑的发生率为12.2%,低于对照组的33.9%,差异有统计学意义(P<0.05)。结论PDCA循环工具的应用有助于降低患者自行注射预灌式低分子肝素钠皮下瘀斑的发生率。Objective To investigate the application effect of plan-do-check-act(PDCA)cycle in reducing the incidence of subcutaneous ecchymosis of patients with self-injected pre-perfusion low molecular weight heparin sodium.Methods A total of 56 patients who were treated in the First Affiliated Hospital of Xiamen University from March to May 2023 and self-injected pre-perfusion low molecular weight heparin sodium were selected as the control group.A total of 49 patients who were self-injected pre-perfusion low molecular weight heparin sodium from August to October 2023 were selected as the observation group.The control group was guided by the conventional injection process,and the observation group was treated with PDCA cycle tool for injection intervention management.The incidence of subcutaneous ecchymosis by self-injected pre-perfusion low molecular weight heparin sodium was compared between the two groups.Results In the observation group,the incidence of non-rotation of injection site was 20.4%,the incidence of injection without air bubble was 18.4%,the incidence of inaccurate compression technique was 16.3%,the incidence of inaccurate injection depth was 6.1%,and the incidence of insufficient compression time was 4.1%,which were lower than 44.6%,39.3%,35.7%,19.6%,17.9%in the control group,the difference was statistically significant(P<0.05).The pain degree of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).The incidence of subcutaneous ecchymosis in the observation group was 12.2%,which was lower than 33.9%in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of PDCA cycle tool can help reduce the incidence of subcutaneous ecchymosis of patients who were self-injected pre-perfusion low molecular weight heparin sodium.

关 键 词：PDCA 降低 自行注射 预灌式低分子肝素钠 皮下瘀斑 发生率 

分 类 号：R473[医药卫生—护理学]