PDCA在防控NICU新生儿皮肤损伤的应用研究
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摘要
目的分析PDCA在防控新生儿重症监护病房(NICU)新生儿皮肤损伤中的应用价值。方法将我院2017年1月至6月实施PDCA前110例入住NICU的新生儿纳入对照组,另将2017年7月至12月实施PDCA后124例入住NICU的新生儿纳入观察组。对比实施PDCA前后护士护理服务质量(健康教育、病区管理、工作能力、服务态度、形象)、新生儿皮肤损伤(压伤、粘贴伤、静脉穿刺伤、摩擦伤、灼伤)发生率、皮肤感染情况(皮肤感染率、皮肤感染痊愈时间)。结果实施PDCA后,护士健康教育、病区管理、工作能力、服务态度、形象评分均高于实施前,差异有统计学意义(p<0.05)。观察组新生儿皮肤损伤及感染发生率均低于对照组,皮肤感染痊愈时间短于对照组,差异具有统计学意义(p<0.05)。结论 PDCA用于NICU新生儿护理可提高护理服务质量,降低皮肤损伤发生率及感染发生率,具有较好的临床应用价值。
Objective To analyze the application value of PDCA cycle in preventing and controlling neonatal NICU skin injury. Methods A total of 110 neonates admitted to NICU in our hospital from January 2017 to June 2017 were included in the control group when PDCA cycle was not adopted. In addition, 124 NICU neonates admitted from July 2017 to December 2017 were included in the observation group when PDCA cycle was adopted. The quality of nursing service(health education, ward management, working ability, service attitude, appearance), the incidence of skin injury(pressure, paste, venous puncture, friction, burn), and infection(infection rate and recovery time) were compared before and after the implementation of PDCA cycle. Results After the implementation of PDCA cycle, the scores of health education, ward management, work ability, service attitude, appearance for the nurses were higher than before, and the difference was statistically significant(p<0.05). The observation group had lower incidence of skin injury and infection and shorter recovery time than those in the control group, and the difference was statistically significant(p<0.05). Conclusion PDCA cycle can improve the quality of nursing services, reduce the incidence of skin damage and infection rate in NICU neonate care, proved to be of good clinical application value.
Objective To analyze the application value of PDCA cycle in preventing and controlling neonatal NICU skin injury. Methods A total of 110 neonates admitted to NICU in our hospital from January 2017 to June 2017 were included in the control group when PDCA cycle was not adopted. In addition, 124 NICU neonates admitted from July 2017 to December 2017 were included in the observation group when PDCA cycle was adopted. The quality of nursing service(health education, ward management, working ability, service attitude, appearance), the incidence of skin injury(pressure, paste, venous puncture, friction, burn), and infection(infection rate and recovery time) were compared before and after the implementation of PDCA cycle. Results After the implementation of PDCA cycle, the scores of health education, ward management, work ability, service attitude, appearance for the nurses were higher than before, and the difference was statistically significant(p<0.05). The observation group had lower incidence of skin injury and infection and shorter recovery time than those in the control group, and the difference was statistically significant(p<0.05). Conclusion PDCA cycle can improve the quality of nursing services, reduce the incidence of skin damage and infection rate in NICU neonate care, proved to be of good clinical application value.
引文
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13 Leo D,Liew P,Arunachalam S,et al.PO-0546 Lessons From 10Years Of Invasive Fungal Infection At Singapore General Hospital Nicu:Epidemiology,Risks,Clinical Course And Outcomes[J].Archives of Disease in Childhood,2014,99(Suppl 2):A428.3-A428.
14李莉,熊玲,王珊珊,等.PDCA在新生儿静脉留置针中的应用[J].山西医药杂志,2017,46(1):98-100.
2覃月彩,罗春清,梁贻琼,等.PDCA对气管套管护理质量的影响[J].护理学报,2017,24(10):8-10.
3 Bereskie T,Rodriguez MJ,Sadiq R.Drinking Water Management and Governance in Canada:An Innovative Plan-Do-Check-Act(PDCA)Framework for a Safe Drinking Water Supply[J].Environmental Management,2017.
4韩俊林,王润兰,李建华.护理服务质量评价量表的初步研制[J].中国护理管理,2011,11(3):12-15.
5冯俊花,符景秋,黄景妹,等.4R危机管理理论对住院皮肤病患者皮肤感染的影响[J].中华医院感染学杂志,2017,27(4):935-938.
6 Luton A,Hernandez J,Patterson CR,et al.Preventing Pressure Injuries in Neonates Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy[J].Advances in Neonatal Care,2017,17(4):237-244.
7 Lewis T,Erfe BL,Ezell T,et al.Pharmacoepidemiology of opiate use in the Neonatal ICU:Increasing cumulative doses and iatrogenic opiate withdrawal[J].Journal of opioid management,2015,11(4):305-312.
8李海波,吕慧敏,赵雅荣.PDCA法在优质护理质量控制中的应用[J].中国医院管理,2013,33(7):74-75.
9张新.PDCA在降低危重症患儿医源性皮肤损伤的效果观察[J].中国妇幼健康研究,2016,27(s2):25-26.
10 Babu MC,Tandur B,Sharma D,et al.Disposable diapers decrease the incidence of neonatal infections compared to cloth diapers in a level II neonatal intensive care unit[J].Journal of Tropical Pediatrics,2015,61(4):250-254.
11 Huang YC,Lien RI,Lin TY.Effect of mupirocin decolonization on subsequent methicillin-resistant Staphylococcus aureus infection in infants in neonatal intensive care units[J].Pediatric Infectious Disease Journal,2015,34(3):241-5.
12 Aeffner F,Woods PS,Davis IC.Activation of A1-Adenosine Receptors Promotes Leukocyte Recruitment to the Lung and Attenuates Acute Lung Injury in Mice Infected with Influenza A/WSN/33(H1N1)Virus[J].Journal of Virology,2014,88(17):10214-10227.
13 Leo D,Liew P,Arunachalam S,et al.PO-0546 Lessons From 10Years Of Invasive Fungal Infection At Singapore General Hospital Nicu:Epidemiology,Risks,Clinical Course And Outcomes[J].Archives of Disease in Childhood,2014,99(Suppl 2):A428.3-A428.
14李莉,熊玲,王珊珊,等.PDCA在新生儿静脉留置针中的应用[J].山西医药杂志,2017,46(1):98-100.