PDCA在成人急診輸液安全管理中的應(yīng)用

□ 林凌云 LIN Ling-yun 章曉蓉 ZHANG Xiao-rong 任海鷗 REN Hai-ou 謝誠誠 XIE Cheng-cheng 章小芬 ZHANG Xiao-fen

Objective To analyze the effect of PDCA cycle management in adult patient infusion safety management in emergency department. Method A total of 1570 adult patients receiving infusion in emergency department in our hospital in 2016 were included as the control group (routine management)were included in the control group. And 1736 adult patients receiving infusion in emergency department in our hospital in 2017 were included as the observation group (Plan-Do-Check-Act, PDCA cycle management). The nursing care quality, incidence of adverse events, and patients' satisfaction with nursing care of two groups were compared. Results After the implementation of PDCA cycle management, the nursing care quality improved, and patients'satisfaction with nursing was better (p＜0.05). The incidence of adverse events, nursing errors, and doctor-patient disputes in the observation group were significantly lower than those in the control group, and the differences were statistically significant (p＜0.05). Conclusion PDCA cycle management can improve nursing care quality and patients' satisfaction with nursing care, and ensure the safety of infusion.

靜脈輸液是醫(yī)療護(hù)理中最常用的治療手段之一，其中急診輸液在搶救危重患者方面起著舉足輕重的作用，故輸液的安全性尤為重要。PDCA循環(huán)是由美國著名管理專家戴明于1954年根據(jù)信息反饋原理提出，包括：計(jì)劃(Plan)、實(shí)施(Do)、檢查(Check)、處理(Action)，是廣泛應(yīng)用于質(zhì)量管理的標(biāo)準(zhǔn)化、科學(xué)化的循環(huán)體系[1]。急診科護(hù)士工作任務(wù)繁重，不但要承擔(dān)搶救工作，也要負(fù)責(zé)輸液、護(hù)理等日常工作，容易因?yàn)榕c患者溝通較少而出現(xiàn)糾紛，引起護(hù)患矛盾。本研究以我院實(shí)施PDCA循環(huán)管理前(2016年1月至2016年12月)與管理后(2017年1月至2017年12月)成人急診輸液患者為研究對(duì)象，探討PDCA循環(huán)管理在提升護(hù)理質(zhì)量、患者滿意度及保障患者安全性方面的作用。

資料與方法

1.一般資料。將我院2016年1月至2016年12月實(shí)施PDCA循環(huán)管理前(行常規(guī)管理)收治的1570例成人急診輸液病例納入對(duì)照組，另將2017年1月至2017年12月實(shí)施PDCA循環(huán)管理后收治的1736例成人急診輸液病例納入觀察組。本研究方案經(jīng)醫(yī)院醫(yī)學(xué)倫理委員會(huì)審核通過。

對(duì)照組男836例，女734例；平均年齡47.5±6.1歲。觀察組男962例，女774例；平均年齡47.1±6.1歲。所有患者均進(jìn)行1次及以上靜脈輸液治療，排除中途放棄輸液者。兩組患者性別、年齡方面比較，差異無統(tǒng)計(jì)學(xué)意義(p＞0.05)。

本研究期間急診科12名護(hù)士未發(fā)生人事變動(dòng)。

2.方法。對(duì)照組：采用急診輸液室常規(guī)工作規(guī)范進(jìn)行輸液和護(hù)理，在患者進(jìn)行急診輸液前，仔細(xì)核對(duì)所輸液的藥物，避免發(fā)生差錯(cuò)，嚴(yán)格執(zhí)行工作規(guī)范進(jìn)行輸液工作?！?br>