质量控制圈在规范临床医生换药中的应用

Yanchun Wan, Jian-jun Huang, Shuyan Li, Jiaying Chen
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引用次数: 0

摘要

目的了解某医院外科换药标准的执行情况及影响其执行的相关因素,为提高临床医生换药标准制定相应的对策。方法2018年2 - 9月,通过选题、制定计划、控制现状、设定目标、分析原因、提出并实施对策、确认效果、规范流程,全面发挥质控圈(QCC)作用,开展质控圈活动。在PDCA循环的基础上不断提高质量,并对效果进行评价。本研究采用自我控制研究;成立“手拉手圈”QCC活动团队;使用质量管理工具;采用自行设计的换药技能评估表和换药不规范原因问卷对77名临床医生进行问卷调查和观察,比较QCC干预前后的标准率提高情况。采用SPSS 20.0进行t检验和χ2检验。结果QCC活性后,换药相对质量指标显著提高。活动前平均得分为(80.45±9.42)分,活动后平均得分为(90.06±3.43)分(P<0.01)。临床医师换药标准率由活动前的57.14%提高到活动后的98.70% (P<0.01),达到90.98%的目标值。QCC活动结束后,着装合格率、手卫生措施执行率、消毒隔离措施合格率、无菌操作合格率、处置物品合格率均显著提高。此外,圈子成员的能力也有不同程度的提高。结论QCC活动可持续提高质量,取得良好效果。QCC质量管理能有效解决感染管理中存在的问题,是实现感染管理规范化、规范化、科学化的有效工具。关键词:品管圈;临床医师;换药;标准税率
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Application of quality control circle in standardizing dressing change among clinical physicians
Objective To investigate the implementation of surgical dressing change standard and related factors influencing the implementation in a hospital, and to formulate the corresponding countermeasure for improving the dressing change standardization of clinicians. Methods From February to September, 2018, the quality control circle (QCC) was comprehensively exerted and QCC activities were implemented through selecting topic, making plans, controlling current status, setting goals, analyzing causes, proposing and practicing countermeasures, confirming effects and standardizing the process. The quality was continuously improved on the basis of the PDCA cycle and effects were evaluated. In this study, self-control study was used; QCC activity team of "hand-in-hand circle" was set up; quality management tools were used; self-designed assessment table of dressing change skills and questionnaire for nonstandard reasons of dressing change were used to conduct the questionnaire survey and observation for 77 clinicians, and improvement of standard rate before and after the QCC intervention was compared. SPSS 20.0 was used to perform the t-test and χ2 test. Results After QCC activity, relative quality indexes of dressing change were significantly increased. The pre-activity average score was (80.45±9.42) and the post-activity average score was (90.06±3.43) (P<0.01). The standard rate of dressing change of the clinical physician was increased from pre-activity 57.14% to post-activity 98.70% (P<0.01), which reached the target value of 90.98%. After QCC activity, dress standard rate, enforced rate of hand hygiene measures, qualification rates of disinfection isolation measures, aseptic operation and disposed items were improved significantly. In addition, the ability of circle members also improved differently. Conclusion QCC activities can continuously improve the quality, obtaining good results. Quality management of QCC can effectively solve problems in infection management, which is an effective tool in the standardization, normalization and scientization of infection management. Key words: Quality control circle; Clinicians; Dressing change; Standard rate
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