基于QFD创新型品管圈的危重患者连续性肾脏替代治疗管理模式构建  

Construction of Continuous Renal Replacement Therapy Management Mode for Critically Ill Patients Based on QFD Innovative Quality Control Circle

作　　者：贾雪丽[1] 李靖靖 包满珍[1] 张淼[1] 金宗兰 朱桂月 张晓婉 占宏林 赵茜云 杨锡瑶[1] JIA Xueli;LI Jingjing;BAO Manzhen(The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230601,China;不详)

机构地区：[1]安徽医科大学第二附属医院,安徽合肥230601

出　　处：《中国卫生质量管理》2025年第2期62-68,共7页Chinese Health Quality Management

基　　金：中华护理学会静脉治疗护理专项科研项目——以护士为主导的血液净化相关静脉导管相关血流感染MDT管理模式的构建及验证(编号:ZHHLZZS-202344);安徽省教育厅高校科研项目自然科学类重点项目——维持性血液透析患者感染现状、危险因素及预防控制策略的队列研究(编号:2023AH053159)。

摘　　要：目的构建危重患者连续性肾脏替代治疗(CRRT)管理模式,提高危重患者CRRT质量。方法应用QFD创新型品管圈,从医生、护士、患者、工程师4方面梳理危重患者CRRT过程需求,运用KJ法、Kano模型识别关键质量特性,结合TRIZ理论及FMEA方法,转化为具体的管理策略,实施质量改进。结果活动后,计划下机率上升至92.5%,交付剂量达标率上升至88.9%,理论技能考核达标率上升至95.2%,透析导管并发症发生率下降至3.0%,医护工作满意度上升至96.0%,设备维护合格率达100%,患者满意度上升至96.0%。结论通过开展QFD创新型品管圈活动,能够改善危重患者CRRT过程中存在的问题,为临床改进提供依据,从而提高危重患者CRRT质量,提升患者满意度,改善患者就医体验。Objective To establish a continuous renal replacement therapy(CRRT)management mode for critically ill patients and improve the quality of CRRT.Methods QFD innovative quality control circle was applied to sort out the CRRT process requirements of critically ill patients from four aspects:doctors,nurses,patients and engineers.KJ method and Kano model were used to identify key quality characteristics.TRIZ theory and FMEA method were combined to transform them into specific management strategies and implement quality improvement.Results After the activity,the planned discharge increased to 92.5%,the delivery dose compliance rate increased to 88.9%,the theoretical skill assessment compliance rate increased to 95.2%,the incidence of dialysis catheter complication decreased to 3.0%,the satisfaction of medical care increased to 96.0%,the qualified rate of equipment maintenance reached 100%,and the patient satisfaction increased to 96.0%.Conclusion The application of QFD innovative quality control circle can improve the problems in the process of CRRT in critically ill patients,provide the basis for clinical improvement,so as to enhance the quality of CRRT in critically ill patients,boost patient satisfaction,and improve the patient medical experience.

关 键 词：质量功能展开(QFD) 品管圈(QCC) QFD创新型品管圈 危重患者 连续性肾脏替代治疗(CRRT) 

分 类 号：R197.323[医药卫生—卫生事业管理] R459.5[医药卫生—公共卫生与预防医学]