品管圈活动在中心静脉留置导管血液透析患者中的应用效果
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摘要
目的探讨品管圈(quality control circle,QCC)活动在中心静脉留置导管血液透析患者中的应用效果。方法收集南昌大学第一附属医院2017年1—10月血液净化中心收治的260例行中心静脉留置导管血液透析治疗患者,将QCC活动实施前(1—3月)收治的115例设为对照组,QCC活动实施后(4—10月)收治的145例设为观察组。比较2组患者中心静脉留置导管相关性感染发生率、患者护理满意度及QCC小组成员综合素质能力(包括QCC应用能力、合作意识、主动意识、问题意识、改进意识、沟通协调能力6个方面)评分。结果观察组患者中心静脉留置导管相关性感染发生率较对照组显著降低(6.4%比13.3%,χ~2=11.290、P=0.001),患者护理满意度较对照组显著升高(96.8%比89.5%,χ~2=5.123、P=0.024);QCC小组成员综合素质能力各指标评分均较QCC小组成立前显著提高(P<0.01)。结论在血液透析治疗中开展QCC活动,可有效降低中心静脉留置导管感染发生率,提高患者护理满意度,且可提升护理人员综合素质能力。
Objective To explore the efficacy of quality control circle(QCC)activities in hemodialysis patients with central venous indwelling catheter.Methods A total of 260 patients undergoing central venous indwelling catheter hemodialysis in the First Affiliated Hospital of Nanchang University between January and October 2017 were divided into two groups:115 patients treated before the implementation of QCC activities(January-March)were selected as the control group,and 145 patients treated after the implementation of QCC activities(from April-October)as the observation group.The incidence of central venous indwelling catheter-related infections,patient satisfaction with nursing care and comprehensive quality and ability scores(including QCC application ability,cooperation awareness,initiative awareness,problem awareness,improvement awareness,and communication and coordination ability)of QCC members were compared between the two groups.Results Compared with control group,QCC activities reduced the incidence of central venous indwelling catheter-related infections(6.4% vs 13.3%,χ~2=11.290,P=0.001),elevated the patient satisfaction with nursing care(96.8% vs 89.5%,χ~2=5.123,P =0.024),and increased the comprehensive quality and ability scores(P<0.01).Conclusion The implementation of QCC activities can effectively reduce the incidence of central venous indwelling catheter-related infections,enhance patient satisfaction with nursing care and improve comprehensive quality of nursing staff.
Objective To explore the efficacy of quality control circle(QCC)activities in hemodialysis patients with central venous indwelling catheter.Methods A total of 260 patients undergoing central venous indwelling catheter hemodialysis in the First Affiliated Hospital of Nanchang University between January and October 2017 were divided into two groups:115 patients treated before the implementation of QCC activities(January-March)were selected as the control group,and 145 patients treated after the implementation of QCC activities(from April-October)as the observation group.The incidence of central venous indwelling catheter-related infections,patient satisfaction with nursing care and comprehensive quality and ability scores(including QCC application ability,cooperation awareness,initiative awareness,problem awareness,improvement awareness,and communication and coordination ability)of QCC members were compared between the two groups.Results Compared with control group,QCC activities reduced the incidence of central venous indwelling catheter-related infections(6.4% vs 13.3%,χ~2=11.290,P=0.001),elevated the patient satisfaction with nursing care(96.8% vs 89.5%,χ~2=5.123,P =0.024),and increased the comprehensive quality and ability scores(P<0.01).Conclusion The implementation of QCC activities can effectively reduce the incidence of central venous indwelling catheter-related infections,enhance patient satisfaction with nursing care and improve comprehensive quality of nursing staff.
引文
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[5]戴芳,张洁,王雪梅,等.品管圈在降低深静脉置管穿刺局部感染率的应用[J].临床医学,2016,29(20):194-195.
[6]陆莹.护理行为与护理安全管理[J].护理管理杂志,2002,2(4):11-13.
[7]Chopra V,Anand S,Krein S L,et al.Bloodstream infection,venous thrombosis,and peripherally inserted central catheters:reappraising the evidence[J].AJM,2012,125(8):733-741.
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[9]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,2014,13(11):800-801.
[10]吴小红.以QC文化提升护理服务质量[J].中国卫生质量管理,2012,19(6):455-467.
[11]杨家祯.品管圈对血液透析室中心静脉留置导管感染率管理效果影响[J].中国实用医药,2016,11(1):290-291.
[12]陈玲.品管圈在血液透析室护理质量控制中的运用与成效[J].影像研究与医学应用,2018,2(16):188-189.
[13]张莉,赵海燕,刘黎明,等.品管圈活动在降低透析导管感染中的应用[J].吉林医学,2015,36(3):521-522.
[14]吴健谊,彭爱民,杨克举.品管圈活动对降低血液透析导管相关感染的应用分析[J].中华医院感染学杂志,2015,25(14):3347-3349.
[15]卢美珠,杜海红,庞树英,等.运用品管圈降低患者PICC留置期间导管感染发生率[J].吉林医学,2014,35(27):6117-6118.
[2]方卫东,黄其鹏,任称发,等.血液透析患者导管相关性血流感染发生率及危险因素分析[J].当代医学,2016,22(17):20-21.
[3]张竹,唐慧,景艳红.血液透析患者临时中心静脉置管的维护[J].中外女性健康研究,2015,19(21):58.
[4]姜艳华,王靖.维持性血液透析患者中心静脉留置导管带管体验的研究[J].上海护理,2017,17(6):16-20.
[5]戴芳,张洁,王雪梅,等.品管圈在降低深静脉置管穿刺局部感染率的应用[J].临床医学,2016,29(20):194-195.
[6]陆莹.护理行为与护理安全管理[J].护理管理杂志,2002,2(4):11-13.
[7]Chopra V,Anand S,Krein S L,et al.Bloodstream infection,venous thrombosis,and peripherally inserted central catheters:reappraising the evidence[J].AJM,2012,125(8):733-741.
[8]吴燕,骆益春,王沪渝.实行QCI小组管理,持续改进护理质量[J].全科护理,2010,8(5):1286-1287.
[9]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,2014,13(11):800-801.
[10]吴小红.以QC文化提升护理服务质量[J].中国卫生质量管理,2012,19(6):455-467.
[11]杨家祯.品管圈对血液透析室中心静脉留置导管感染率管理效果影响[J].中国实用医药,2016,11(1):290-291.
[12]陈玲.品管圈在血液透析室护理质量控制中的运用与成效[J].影像研究与医学应用,2018,2(16):188-189.
[13]张莉,赵海燕,刘黎明,等.品管圈活动在降低透析导管感染中的应用[J].吉林医学,2015,36(3):521-522.
[14]吴健谊,彭爱民,杨克举.品管圈活动对降低血液透析导管相关感染的应用分析[J].中华医院感染学杂志,2015,25(14):3347-3349.
[15]卢美珠,杜海红,庞树英,等.运用品管圈降低患者PICC留置期间导管感染发生率[J].吉林医学,2014,35(27):6117-6118.