应用FOCUS-PDCA程序提高SPECT图像质量合格率
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摘要
目的应用焦点管理循环(FOCUS-PDCA)(发现、组织、澄清、理解、选择、计划、实施、检查和执行)程序,提高单光子发射体层摄影术(SPECT)图像质量合格率。方法选择2015年6月至10月456例患者SPECT图像资料作对照组,其中男性209例,女性247例;年龄39～80岁,平均年龄53.5岁;肺癌343例,乳腺癌56例,前列腺癌34例,胃癌、肝癌及心脏、肾脏疾病等23例。选择2016年3月至5月改进后582例患者SPECT图像资料为试验组,其中男性235例,女性347例;年龄31～82岁,平均年龄54.7岁;肺癌363例,乳腺癌117例,前列腺癌56例,胃癌、肝癌及心脏、肾脏疾病等46例。分析对照组影响图像质量的因素,采用FOCUS-PDCA程序进行改进,比较改进后情况。结果 2016年应用FOCUS-PDCA程序持续改进后,试验组图像的不合格率降低为5.67%(33/582),与2015年对照组[13.82%(63/456)]比较,不合格率降低,差异具有统计学意义(χ~2=4.761,P<0.05)。结论应用FOCUS-PDCA程序可以有效改进SPECT检查中各环节操作、流程,有利于SPECT图像质量的提升。
Objective To improve the single photon emission computed tomography(SPECT) image quality rate by focus management cycle(FOCUS-PDCA) program(discover, organize, clarify, understand, select, plan, implement, check, and execute).Methods SPECT images data of 456 cases from June to October 2015(343 of lung cancer, 56 of breast cancer, 34 of prostate cancer, 23 of gastric cancer, liver cancer and heart and kidney disease) were selected as control group, which included 209 males and 247 females, aged 39-80 years old with mean age of 53.5 years old. Improved SPECT image data of 582 cases from March to May in 2016(363 of lung cancer, 117 of breast cancer, 56 of prostate cancer, 46 of gastric cancer, liver cancer and heart and kidney disease) were selected as experimental group, which included 235 males and 347 females, aged 31-82 years old with mean age of 54.7 years old. The factors affecting image quality of the control group were analyzed, and the FOCUSPDCA program was improved and compared. Results After the continuous improvement of FOCUS-PDCA program in 2016, the unqualified rate of image in experimental group was reduced to 5.67 %(33/582), compared with control group[13.82 %(63/456)],the difference of unqualified rate was statistically significant(χ~2 = 4.761, P < 0.05). Conclusion It is demonstrated that the FOCUS-PDCA program could effectively improve the operation and flow in SPECT, which is beneficial to the improvement of SPECT image quality.
Objective To improve the single photon emission computed tomography(SPECT) image quality rate by focus management cycle(FOCUS-PDCA) program(discover, organize, clarify, understand, select, plan, implement, check, and execute).Methods SPECT images data of 456 cases from June to October 2015(343 of lung cancer, 56 of breast cancer, 34 of prostate cancer, 23 of gastric cancer, liver cancer and heart and kidney disease) were selected as control group, which included 209 males and 247 females, aged 39-80 years old with mean age of 53.5 years old. Improved SPECT image data of 582 cases from March to May in 2016(363 of lung cancer, 117 of breast cancer, 56 of prostate cancer, 46 of gastric cancer, liver cancer and heart and kidney disease) were selected as experimental group, which included 235 males and 347 females, aged 31-82 years old with mean age of 54.7 years old. The factors affecting image quality of the control group were analyzed, and the FOCUSPDCA program was improved and compared. Results After the continuous improvement of FOCUS-PDCA program in 2016, the unqualified rate of image in experimental group was reduced to 5.67 %(33/582), compared with control group[13.82 %(63/456)],the difference of unqualified rate was statistically significant(χ~2 = 4.761, P < 0.05). Conclusion It is demonstrated that the FOCUS-PDCA program could effectively improve the operation and flow in SPECT, which is beneficial to the improvement of SPECT image quality.
引文
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[11] HUANG Ke-min, FENG Yan-lin, LIANG Wei-tang, et al.Absolute quantitative phantom of SPECT/CT imaging based on specified reconstruction algorithms and correction methods[J]. Chinese Journal of Nuclear Medicine Molecular Imaging,2018, 38(5):340-344.[黄克敏,冯彦林,梁伟棠,等.基于特定重建算法及校正方法的SPECT/CT绝对定量模型研究[J].中华核医学与分子影像杂志,2018,38(5):340-344.]
[12] ZHANG Jie, MA Li, LI Shun-hua, et al. Quality control and quality assurance of single photon emission computed tomography system[J]. Journal of China Clinic Medical Imaging,2009, 20(1):67-68.[张洁,马丽,李顺华,等.SPECT仪器质量控制和质量保证的初步探讨[J].中国医学影像杂志,2009,20(1):67-68.]
[13] ZHANG Meng. Quality control of SPECT/CT based on PDCA management[J]. China Medical Devices, 2016, 31(5):178-180.[张梦.基于PDCA管理的SPECT/CT质量控制[J].中国医疗设备,2016,31(5):178-180.]
[14] ZHANG Pei-pei. Application of FOCUS-PDCA program in fall management of patients in the department of cardiology[J]. Clinical Education of General Practice, 2015, 13(6):705-707.[章培培.FOCUS-PDCA程序在预防心内科患者跌倒管理中的应用[J].全科医学临床与教育,2015,13(6):705-707.]
[15] YUAN Wang, WANG Mei-yu, HAN Chun-ying, et al. Study on improvement of the effect of infection control in radiology department using PDCA circulation[J]. Foreign Medical Sciences:Section of Medgeography,2015, 36(2):109-112.[袁网,王美玉,韩春莹,等.运用PDCA循环提高医学影像科感染控制效果的研究[J].国外医学:医学地理分册,2015,36(2):109-112.]
[16] CAO Yue-ting, HE Wen-ting, ZUO Yu-jin, et al. Application of PDCA theory in independent management of nursing laboratory items[J]. Nursing Practice and Research, 2016, 13(12):130-131.[曹月婷,何文婷,左玉金,等.PDCA理论在护理实验室物品自主管理中的应用[J].护理实践与研究,2016,13(12):130-131.]
[17] SUN Hui-hua, YANG Li-ying, XIANG Meng-jiao, et al. Using FOCUS PDCA program to reduce incidence of wet bags for sterilization of foreign medical devices[J]. Chinese Nursing Research,2018, 32(14):2232-2237.[孙惠华,杨利英,项梦娇,等.运用FOCUS PDCA程序降低外来医疗器械灭菌湿包发生率[J].护理研究,2018,32(14):2232-2237.]
[2] SHI Hong-cheng. Clinical application of SPECT/CT:using its advantage over other medical imaging modalities[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging,2017, 37(7):385-387.[石洪成.SPECT/CT的临床应用:在优势互补中寻求亮点[J].中华核医学与分子影像杂志,2017,37(7):385-387.]
[3] DUAN Yong-qiang, YU Hui, CHEN Yuan-hao, et al.~(99)Tc~mMDP scintigraphy and treatment after resection for thyroid adenocarcinoma metastasis:one case report[J]. Journal of Medical Imaging,2015,25(3):473-474.[段永强,余辉,陈援浩,等.甲状腺癌转移灶切除术后~(99)Tc~m-MDP骨显像与治疗1例[J].医学影像学杂志,2015,25(3):473-474.]
[4] DONG Ke, SHI Hong-cheng, LIU Jiang, et al. The value of SPECT/CT imaging for follow-up of bone metastasis[J]. Chinese Journal of Nuclear Medicine and Molecular Imaging,2013, 33(3):199-202.[董科,石洪成,刘江,等.SPECT/CT显像在肿瘤骨转移同一病灶动态随访中的价值[J].中华核医学与分子影像杂志,2013,33(3):199-202.]
[5] GENG Jian-hua, CHEN Ying-mao. Development and status of quality control and standard for nuclear medicine imaging equipment[J].Chinese Journal of Nuclear Medicine and Molecular Imaging, 2015, 35(1):75-78.[耿建华,陈英茂.核医学成像设备的质量控制标准及中国质量控制现状[J].中华核医学与分子影像杂志,2015,35(1):75-78.]
[6] LI Ji-hou. Analysis of factors affecting quality of SPECT fault images[J]. Chinese Medical Equipment Journal, 2004, 25(11):55-55, 57-57.[李积厚.影响SPECT断层图像质量的因素分析[J].医疗卫生装备,2004,25(11):55-55,57-57.]
[7] XU Chang-long, GUO Xiao-min, ZHANG Lian-jie, et al. Application status quo of FOCUS-PDCA program in nursingmanagement[J]. Chinese Nursing Research, 2017, 31(1):15-17.[徐长龙,郭晓敏,张连杰,等.FOCUS-PDCA程序在护理管理中的应用现状[J].护理研究,2017,31(1):15-17.]
[8] Ovretveit J. A team quality improvement sequence for complex problems[J]. Qual Health Care, 1999, 8(4):239-246.
[9] FENG Li-juan, TONG Jin, SUN Shan-shan, et al. Application of pressure injectable PICC in intravenous bolus injection for imaging examinations[J]. Journal of Nursing Science,2014, 29(20):10-12.[冯丽娟,童瑾,孙杉杉,等.抗高压PICC在影像检查静脉团注中的应用[J].护理学杂志,2014,29(20):10-12.]
[10] CHEN Yi-wen, JIANG Ting-ting, LIN Wei-li. The application of FOCUS-PDCA in improving in patients awareness rate of health knowledge[J]. China Health Standard Management,2017, 8(16):149-151.[陈毅文,姜亭亭,林伟丽.运用FOCUS-PDCA提高住院患者健康教育知晓率[J].中国卫生标准管理,2017,8(16):149-151.]
[11] HUANG Ke-min, FENG Yan-lin, LIANG Wei-tang, et al.Absolute quantitative phantom of SPECT/CT imaging based on specified reconstruction algorithms and correction methods[J]. Chinese Journal of Nuclear Medicine Molecular Imaging,2018, 38(5):340-344.[黄克敏,冯彦林,梁伟棠,等.基于特定重建算法及校正方法的SPECT/CT绝对定量模型研究[J].中华核医学与分子影像杂志,2018,38(5):340-344.]
[12] ZHANG Jie, MA Li, LI Shun-hua, et al. Quality control and quality assurance of single photon emission computed tomography system[J]. Journal of China Clinic Medical Imaging,2009, 20(1):67-68.[张洁,马丽,李顺华,等.SPECT仪器质量控制和质量保证的初步探讨[J].中国医学影像杂志,2009,20(1):67-68.]
[13] ZHANG Meng. Quality control of SPECT/CT based on PDCA management[J]. China Medical Devices, 2016, 31(5):178-180.[张梦.基于PDCA管理的SPECT/CT质量控制[J].中国医疗设备,2016,31(5):178-180.]
[14] ZHANG Pei-pei. Application of FOCUS-PDCA program in fall management of patients in the department of cardiology[J]. Clinical Education of General Practice, 2015, 13(6):705-707.[章培培.FOCUS-PDCA程序在预防心内科患者跌倒管理中的应用[J].全科医学临床与教育,2015,13(6):705-707.]
[15] YUAN Wang, WANG Mei-yu, HAN Chun-ying, et al. Study on improvement of the effect of infection control in radiology department using PDCA circulation[J]. Foreign Medical Sciences:Section of Medgeography,2015, 36(2):109-112.[袁网,王美玉,韩春莹,等.运用PDCA循环提高医学影像科感染控制效果的研究[J].国外医学:医学地理分册,2015,36(2):109-112.]
[16] CAO Yue-ting, HE Wen-ting, ZUO Yu-jin, et al. Application of PDCA theory in independent management of nursing laboratory items[J]. Nursing Practice and Research, 2016, 13(12):130-131.[曹月婷,何文婷,左玉金,等.PDCA理论在护理实验室物品自主管理中的应用[J].护理实践与研究,2016,13(12):130-131.]
[17] SUN Hui-hua, YANG Li-ying, XIANG Meng-jiao, et al. Using FOCUS PDCA program to reduce incidence of wet bags for sterilization of foreign medical devices[J]. Chinese Nursing Research,2018, 32(14):2232-2237.[孙惠华,杨利英,项梦娇,等.运用FOCUS PDCA程序降低外来医疗器械灭菌湿包发生率[J].护理研究,2018,32(14):2232-2237.]