探讨品管圈在全院院内压力性损伤管理中的效果观察
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摘要
目的探讨运用品管圈对全院发生压力性损伤管理的效果观察。方法本课题研究小组回顾性分析2016年压力性损伤院内发生数据,品管圈小组对发生数据进行分析及在2017年第1季度进行一次摸底专项检查,通过检查与结合原始数据分析发生院内压力性损伤原因,讨论提出在全院范围内进行培训、整改,进行了多次全员培训,修订上报流程与制度,品管圈小组对重点科室(如ICU、神经外科、手术室)重点督查与培训。品管圈小组根据每季度上报表格数据与专项检查不良条目分析,利用品管圈进行持续质量改进。结果通过利用品管圈对控制全院压力性损伤发生的管理,我们优化了上报流程与制度,优化了全院统计数据表格。对比2016年与2017年全院发生例数与发生科室数据,P <0. 01,说明不同科室在2016年和2017年发生压力性损伤情况有统计学意义,2017年比2016年总体发生压力性损伤发生例数降低;专项检查对比干预前与干预后主要影响压力性损伤发生的不良条目的监控数据显示P <0. 01,表明影响压力性损伤发生的不良条目在干预前后有统计学意义,表明干预后对影响压力性损伤发生的不良条目降低有促进作用。结论在护理指南明确,且该类技术管理治疗标准相对稳定时,在全院现有资源上建议使用品管圈管理工具,能有效提高慢性伤口、造口专科小组对全院压力性损伤管理水平。
Objective To explore the effect of quality control circle( QC) on the management of pressure injury in the hospital.Methods The research group retrospectively analyzed the data of pressure injury in 2016. The QC group analyzed the data and conducted a special inspection in the first quarter of 2017. Based on the analysis of the causes of pressure injuries in hospital with the original data,the training and rectification were carried out in the whole hospital,and several full-time training was carried out,the reporting process and system were revised,and the quality control circle team supervised and trained the key departments( such as ICU,neurosurgery,operating room). Quality control circle group based on quarterly report form data and special inspection analysis of poor items,the use of quality control circle for continuous quality improvement. Results By using the quality control circle to control the occurrence of pressure injury,we optimized the reporting process and system,and optimized the hospital statistical data table. Comparing the number of cases and department data in 2016 and 2017,P < 0. 01 showed that the incidence of pressure injury in different departments in 2016 and 2017 was statistically significant,and the incidence of pressure injury in 2017 was lower than that in 2016. The monitoring data of good items showed that P < 0. 01,indicating that the adverse items affecting the occurrence of pressure injury had statistical significance before and after the intervention,indicating that intervention can promote the reduction of adverse items affecting the occurrence of pressure injury. Conclusion When the nursing guideline is clear and the treatment standard of this kind of technology is relatively stable,it is suggested to use the quality control circle management tool in the existing resources of the whole hospital,which can effectively improve the management level of chronic wound and stoma specialist group.
Objective To explore the effect of quality control circle( QC) on the management of pressure injury in the hospital.Methods The research group retrospectively analyzed the data of pressure injury in 2016. The QC group analyzed the data and conducted a special inspection in the first quarter of 2017. Based on the analysis of the causes of pressure injuries in hospital with the original data,the training and rectification were carried out in the whole hospital,and several full-time training was carried out,the reporting process and system were revised,and the quality control circle team supervised and trained the key departments( such as ICU,neurosurgery,operating room). Quality control circle group based on quarterly report form data and special inspection analysis of poor items,the use of quality control circle for continuous quality improvement. Results By using the quality control circle to control the occurrence of pressure injury,we optimized the reporting process and system,and optimized the hospital statistical data table. Comparing the number of cases and department data in 2016 and 2017,P < 0. 01 showed that the incidence of pressure injury in different departments in 2016 and 2017 was statistically significant,and the incidence of pressure injury in 2017 was lower than that in 2016. The monitoring data of good items showed that P < 0. 01,indicating that the adverse items affecting the occurrence of pressure injury had statistical significance before and after the intervention,indicating that intervention can promote the reduction of adverse items affecting the occurrence of pressure injury. Conclusion When the nursing guideline is clear and the treatment standard of this kind of technology is relatively stable,it is suggested to use the quality control circle management tool in the existing resources of the whole hospital,which can effectively improve the management level of chronic wound and stoma specialist group.
引文
1美国国家压疮咨询委员会.2016年压力性损伤指南.2016.4.13
2 Baumgarten M,Margolis DJ,Localio AR,et al.Extrinsic risk factors for pressure ulcers early in the hospital stay:a nested cage-control study[J].J Gerontol A Biol Sci Med Sci,2008,63(4):408-413.
3 Capon A,Pavoni N,Mastromattei A,et al.Pressure ulcer risk in longterm units:prevalence and associated factors[J].J Adv Nurs,2007,58(3):263-272.
4 Dealey C,Posnett J,Walker A.The cost of pressure ulcers in the United Kingdom[J].J Wound Care,2012,21(6):261-262,264,266.
5 Sullivan N,Schoelles KM.Preventing in-facility pressure ulcers as a patient safety strategy:a systematic review[J].Ann Intem Med,2013,158(5 Pt 2):410-416.
6曾斌,杨琴,李勤.Braden压疮风险评估量表在ICU患者压疮管理中的应用[J].护理研究(上旬版),2012,26(6):1494-1495.
7于彬彬,许红梅,陈晓琳,等.Braden量表对住院患者压疮危险预测效度的Meta分析[J].护理学杂志,2016,31(5):97-101.
8梁铭会,刘庭芳,董四平.品管圈在医疗质量持续改进中的应用研究[J].医院核心竞争力理论探索与案例分析,2012,32(2):37-39.
9孙娜,封宗超,倪静,等.合理缩短平均住院日全面提高医疗质量管理[J].西南军医,2009(2):321-322.
10 Mc Innes E,Jammali-Blasi A,Bell-Syer S,et al.Preventing pressure ulcers:Are pressure-redistributing support surfaces effective?a Cochrane systematic review and meta-analysis[J].Int J Nurs Stud,2012,49(3):345-359.
11孙晓敏,姚英,汪虹,等.手术患者压疮风险预控系统的建立与应用研究[J].护士进修杂志,2018,33(2):108-111.
12柴博微,欧玉兰,欧阳红娟.某综合医院压疮管理的数据分析及实践效果[J].全科护理,2017,15(6):683-685.
13李琳凤,张毅,吕海瑛.品管圈在我国护理质量控制中的应用现状[J].护理管理杂志,2013,13(11):800-801.
2 Baumgarten M,Margolis DJ,Localio AR,et al.Extrinsic risk factors for pressure ulcers early in the hospital stay:a nested cage-control study[J].J Gerontol A Biol Sci Med Sci,2008,63(4):408-413.
3 Capon A,Pavoni N,Mastromattei A,et al.Pressure ulcer risk in longterm units:prevalence and associated factors[J].J Adv Nurs,2007,58(3):263-272.
4 Dealey C,Posnett J,Walker A.The cost of pressure ulcers in the United Kingdom[J].J Wound Care,2012,21(6):261-262,264,266.
5 Sullivan N,Schoelles KM.Preventing in-facility pressure ulcers as a patient safety strategy:a systematic review[J].Ann Intem Med,2013,158(5 Pt 2):410-416.
6曾斌,杨琴,李勤.Braden压疮风险评估量表在ICU患者压疮管理中的应用[J].护理研究(上旬版),2012,26(6):1494-1495.
7于彬彬,许红梅,陈晓琳,等.Braden量表对住院患者压疮危险预测效度的Meta分析[J].护理学杂志,2016,31(5):97-101.
8梁铭会,刘庭芳,董四平.品管圈在医疗质量持续改进中的应用研究[J].医院核心竞争力理论探索与案例分析,2012,32(2):37-39.
9孙娜,封宗超,倪静,等.合理缩短平均住院日全面提高医疗质量管理[J].西南军医,2009(2):321-322.
10 Mc Innes E,Jammali-Blasi A,Bell-Syer S,et al.Preventing pressure ulcers:Are pressure-redistributing support surfaces effective?a Cochrane systematic review and meta-analysis[J].Int J Nurs Stud,2012,49(3):345-359.
11孙晓敏,姚英,汪虹,等.手术患者压疮风险预控系统的建立与应用研究[J].护士进修杂志,2018,33(2):108-111.
12柴博微,欧玉兰,欧阳红娟.某综合医院压疮管理的数据分析及实践效果[J].全科护理,2017,15(6):683-685.
13李琳凤,张毅,吕海瑛.品管圈在我国护理质量控制中的应用现状[J].护理管理杂志,2013,13(11):800-801.