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目的探讨管道专科护理小组运用品管圈降低非计划性拔管的质量分析与改进的效果。方法海南省人民医院综合外科2013年5月成立了品管圈,组建管道专科护理小组,确定“爱护圈”为圈名,对非计划性拔管的现状进行分析,然后从多方面提出改进对策。结果开展品管圈活动前,2013年5月5日到6月5日综合外科带管道患者1 009例,发生非计划性拔管43例,发生率4.26%;开展品管圈活动后,2013年9年24月到10月2日综合外科带管道患者837例,非计划性拔管12例(包括管道自行脱落5例,患者自行拔出3例,管道堵塞2例,导管相关性感染1例,其他1例),发生率1.43%;活动后非计划性拔管率较活动前明显降低(P<0.05)。品管圈活动后最终目标达成率为127.48%。活动后圈员的品管手法、荣誉感、团队精神、责任感、活动信心、沟通协调、促进脑力开发的内容评分均明显高于活动前(P均<0.01)。结论管道专科护理小组运用品管圈活动能降低非计划性拔管的发生,促进圈员各方面能力的提高,改善护理质量。
Objective To investigate the quality analysis and improvement of unplanned extubation by the pipeline specialist care team using quality control ring. Methods Hainan Provincial People’s Hospital General Surgery in May 2013 set up a quality control circle, the formation of the pipeline specialist care team to determine the “love circle” as a ring, the status of unplanned extubation was analyzed, and then from many aspects Improve countermeasures. Results Before conducting QC activities, from January 5 to June 5, 2013, there were 1 009 cases of synthetic surgical patients with pipes, of which 43 cases were unplanned extubations, with an incidence rate of 4.26%. After conducting QC activities, 2013 From April to October 9, 2009, there were 837 patients with integrated surgical tubing and 12 patients with unplanned extubation (including 5 cases of spontaneous detachment, 3 cases of self-extubation, 2 cases of pipeline blockage, 2 cases of catheter-related infection 1 Cases, the other 1 cases), the incidence rate of 1.43%; after unplanned extubation rate was significantly lower than before activity (P <0.05). After the quality control activities, the ultimate goal of reaching 127.48%. After the activity, the quality control, honors, teamwork, responsibility, activity confidence, communication and coordination and mental development of the circle members were significantly higher than those before the activity (all P <0.01). Conclusion The pipeline specialist care team can reduce the incidence of unplanned extubation by using QC activities, promote the improvement of ability of circle staff in all aspects and improve the nursing quality.