Effects of Quality Control Circle Activities for Intravenous Cannula Placement Using Deming Cycle Management: A Case-Controlled Study

Yahui Zhao, Huiling Liu, Qingqing Zhai, Mengying Qi, Xiaolan Wang, Yanhua Shi
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Abstract

The present study aimed to explore the effectiveness of quality control circle (QCC) activities under the guidance of the Deming cycle Management for improving intravenous (IV) cannula placement. A total of 1,035 patients who underwent IV cannula placement from March 2019 to June 2019 in the Department of Hepatobiliary Surgery and Department of Renal and Thoracic Surgery of our hospital were enrolled as the control group, and 1,437 patients who underwent IV cannula placement in the same places as above but from July 2019 to December 2019 were enrolled as the test group. A between-group comparison was performed on intangible and tangible outcomes (duration of IV cannula placement, complications, patient awareness rate of maintenance knowledge of IV cannula, patient satisfaction rate with nursing staff, nurse skills in IV cannula infusion, and maintenance). After QCC activities were implemented, the scores of 11 QCC members in the five aspects of QCC technique application, communication and coordination, sense of responsibility and honor, motivation, and problem-solving ability all improved compared with those before the activities (p < 0.05), and the duration of IV cannula placement in the test group was 70.22 ±48.33 h, which was longer (p < 0.05) than the 60.59±41.9 h of the control group. The test group had a significantly lower (p < 0.05) rate of complications (12.9%, 12.6%, and 1.3% for extravasation, phlebitis, and cannula obstruction, respectively) than the control group (30.0%, 11.4%, and 4.1% for blood oozing, phlebitis, and cannula obstruction respectively); the patient awareness rate of maintenance knowledge of IV cannula and patient satisfaction rate with nursing staff in the test group were 90% and 96.3%, respectively, which were significantly higher (p < 0.05) than the 82.4% and 81.5% in the control group. The scores of nurse skills in IV cannula infusion and maintenance in the test group were 90.5 ±1.3 and 93.6 ±2.0, respectively, which were significantly higher (p < 0.05) than the 85.5 ±2.7 and 81 ±1.0 in the control group. The implementation of QCC activities under the guidance of the Deming cycle Management in IV cannula placement improves the ability of the department’s nursing team to identify, analyze, and solve problems, which is favorable for continuous improvement of nursing quality, leading to an elongated duration of IV cannula placement, reduced rate of complications, and improved patient satisfaction rate with nursing services.
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采用戴明周期管理的品管圈活动对静脉置管的影响:一项病例对照研究
本研究旨在探讨在戴明周期管理的指导下,质量控制圈(QCC)活动对改善静脉(IV)置管的有效性。选取2019年3月至2019年6月在我院肝胆外科和肾胸外科静脉置管的患者1035例作为对照组,2019年7月至2019年12月在同一地点静脉置管的患者1437例作为试验组。两组间比较无形指标和有形指标(静脉置管时间、并发症、患者对静脉置管维持知识的知知率、患者对护理人员的满意率、护士对静脉置管输注和维持的技能)。QCC活动实施后,11名QCC成员在QCC技术应用、沟通协调、责任荣誉感、动力、问题解决能力5个方面的得分均较活动前有所提高(p < 0.05),实验组留置静脉插管时间为70.22±48.33 h,较对照组的60.59±41.9 h延长(p < 0.05)。试验组并发症发生率(外渗、静脉炎、插管阻塞分别为12.9%、12.6%、1.3%)显著低于对照组(渗血、静脉炎、插管阻塞分别为30.0%、11.4%、4.1%)(p < 0.05);试验组患者对静脉插管维持知识知知率为90%,对护理人员满意度为96.3%,显著高于对照组的82.4%和81.5% (p < 0.05)。试验组在静脉输液和维持护理技能得分分别为90.5±1.3分和93.6±2.0分,显著高于对照组的85.5±2.7分和81±1.0分(p < 0.05)。在戴明周期管理的指导下,在静脉置管中开展QCC活动,提高了科室护理团队发现问题、分析问题、解决问题的能力,有利于护理质量的不断提高,延长了静脉置管时间,降低了并发症发生率,提高了患者对护理服务的满意度。
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