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目的探讨PDCA管理系统下的APN排班及层级责任制护理对提高护理质量的影响。方法 2013年8月—2014年6月该院采用PDCA管理法对骨科、烧伤整形科、呼吸内科等科室护士的岗位职责、APN排班以及分层级使用进行重新界定和计划,并予以实施、检查和评价,并与2012年8月—2013年7月未实施前各科室护理质量进行对比。结果实施PDCA管理后,护士病区管理、护理质量、病历文书书写质量、患者满意度均显著高于实施前(t=10.6779,P<0.05;t=16.0282,P<0.05;t=14.2013,P<0.05;t=12.5260,P<0.05);护理差错、纠纷以及缺陷的发生率明显低于实施前(χ~2=4.8673,P<0.05;χ~2=4.7111,P<0.05;χ~2=4.6491,P<0.05)。结论 PDCA管理系统使层级管理责任制与APN排班有机结合,提高了护理质量以及工作效率,减轻了安全隐患,值得临床推广。
Objective To explore the impact of APN scheduling and hierarchical liability management on improving nursing quality under the PDCA management system. Methods From August 2013 to June 2014, the hospital adopted the PDCA management method to redefine and plan the job responsibilities of nurses in department of orthopedics, burn and plastic surgery, respiratory medicine and other departments, APN scheduling and hierarchical use, and implement it. Inspection and evaluation, and compared with the quality of care of various departments before August 2012 -2013 July. Results After the implementation of PDCA, the nurses’ ward management, quality of care, quality of medical record writing and patient satisfaction were significantly higher than before implementation (t = 10.6779, P <0.05; t = 16.0282, P <0.05; t = 14.2013, P (P <0.05; t = 12.5260, P <0.05). The incidences of nursing errors, disputes and defects were significantly lower than those before implementation (χ ~ 2 = 4.8673, = 4.6491, P <0.05). Conclusions The PDCA management system organically integrates the hierarchical management responsibility system and the APN scheduling so as to improve the quality of nursing care and work efficiency, reduce the potential safety hazard and deserve clinical promotion.