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目的:探讨品管圈(QCC)在手术室外来器械管理中应用价值。方法:由8人组成主题为“外来手术器械持续质量改进”的QCC,调查手术室外来器械管理存在的问题并采取整改措施。通过比较QCC实施前后手术室外来器械的应用、护理人员素质和医师满意度的变化,评价QCC的效果。结果:QCC实施前手术室外来器械准时配送率、器械清点率、湿包率、手术排序调整率及医师满意率分别为76.03%、0、0.53%、1.33%和78.03%;QCC实施后则分别为87.05%、100%、0.13%、0.60%和92.01%。QCC实施后各项指标均有改善(P<0.05)。QCC前护理人员的外来器械的准备意识、发现并解决问题能力、QCC活动能力、持续改进能力、合作能力及学习新知识新理论能力的评分分别为(52.32±5.02)分、(65.30±8.10)分、(54.62±6.01)分、(40.32±7.20)分、(60.12±4.32)分和(55.49±6.32)分;而QCC实施后评分分别为(75.62±7.30)分、(90.30±2.31)分、(88.52±5.31)分、(76.54±4.32)分、(88.52±4.11)分和(79.21±8.55)分。在QCC中护理人员各项素质明显提高(P<0.05)。结论:“外来手术器械持续质量改进”QCC对外来器械的质量管理有持续改善作用,具有明显临床价值,值得推广应用。
Objective: To explore the value of QCC in the management of surgical instruments outside the operating room. Methods: A QCC with the theme of Continuous Quality Improvement of External Surgical Instruments was set up by 8 people to investigate the problems existing in the management of surgical instruments outside the operating room and take corrective measures. The effect of QCC was evaluated by comparing the use of surgical instruments before and after QCC implementation, the quality of nursing staff and the change of physician satisfaction. Results: The on-time delivery rate, device inventory rate, wet pack rate, surgical order adjustment rate and physician satisfaction rate before operating QCC were 76.03%, 0,0.53%, 1.33% and 78.03%, respectively; while after QCC implementation, 87.05%, 100%, 0.13%, 0.60% and 92.01%. After the implementation of QCC indicators improved (P <0.05). (52.32 ± 5.02) points and (65.30 ± 8.10) points respectively for the preparedness of foreign instruments before QCC nurses, ability to find and solve problems, QCC activity ability, continual improvement ability, cooperative ability and new theoretical knowledge of new knowledge. (54.62 ± 6.01), (40.32 ± 7.20) points, (60.12 ± 4.32) points and (55.49 ± 6.32) points respectively, while the score of QCC was (75.62 ± 7.30) points and (90.30 ± 2.31) points respectively , (88.52 ± 5.31) points, (76.54 ± 4.32) points, (88.52 ± 4.11) points and (79.21 ± 8.55) points respectively. The quality of nursing staff in QCC was significantly improved (P <0.05). CONCLUSIONS: Continuous improvement of quality of external surgical instruments QCC has continuous improvement on the quality management of foreign instruments, which has obvious clinical value and is worth popularizing and applying.