运用FOCUS-PDCA在急诊抢救患者中的应用

Application of find-organize-clarify-understand-select-plan-do-check-act in emergency rescue of patients

目的 探讨运用FOCUS-PDCA在缩短急诊抢救患者发血平均时长的成效。方法 收集2022年1月—7月医院输血科收到的急诊抢救患者用血申请单125份作为对照组;开展FOCUS-PDCA后,收集2022年8月—12月院输血科收到的急诊抢救患者用血申请单103份作为观察组。对照组按照旧的急诊用血流程,观察组采用新的急诊用血流程,记录收、发血时间截点及血型报告时间点,对2组在急诊抢救患者发血平均时长、急诊备血血型报告时长方面进行比较。结果 通过运用FOCUS-PDCA,改进急诊用血流程,急诊抢救患者发血平均时长由原来的31 min缩短至22 min,达标率为150%,进步率为29%;急诊备血血型报告平均时长由原来的139 min缩短至27 min,达标率为103%,进步率为81%,改善前后时长差异有统计学意义(P<0.05)。结论 本次运用FOCUS-PDCA改进急诊抢救患者的配血流程,有效缩短患者输血等待时间,大幅度缩短急诊备血血型报告平均时间,提高抢救成功率,持续改进有成效,提高了临床对急救用血的满意度。

Objective This paper aims to explore the effect of find-organize-clarify-understand-select-plan-do-check-act(FOCUS-PDCA)in shortening the average blood matching time for emergency patients.Methods A total of 125 blood application forms received by the blood transfusion department of our hospital from January 2022 to July 2022 were collected as the control group.After the implementation of FOCUS-PDCA,103 blood application forms received by the blood transfusion department from August 2022 to December 2022 were collected as the observation group.The control group followed the usual emergency procedure,while the observation group adopted a new emergency procedure,and the cut-off point of blood collection and blood type reporting time were recorded.The two groups were compared in terms of the average blood matching time for emergency patients and the time of blood type reporting in emergency preparation.Results By using FOCUS-PDCA,the procedure of emergency blood use was improved.The average blood matching time for emergency patients was shortened from 31 min to 22 min,with the standard reaching rate of 150%,and the improvement rate was 29%.The average reporting time of emergency blood preparation was shortened from 139 min to 27 min,with the standard reaching rate of 103%,and the improvement rate was 81%;the differences above between before and after improvement were statistically significant(P<0.05).Conclusion FOCUS-PDCA improves the blood matching procedure for emergency patients,effectively shortens the preparation time for transfusion,significantly shorten the average time of emergency blood type report,improve the success rate of rescue,and achieve continuous improvement results,improving clinical satisfaction with emergency blood use.