前馈质量控制在降低ICU患者意外拔管中的应用

Feed-forward quality control in reducing accidental extubation in ICU patients

目的 采用前馈质量控制管理方法,降低ICU患者意外拔管的发生率.方法 选取2011年1月至2012年1月的患者232例,未实施前馈质量控制管理的为常规组,共置管457例次;2012年2月至2013年1月的238例实施前馈质量控制管理的为质控组,共置管533例次;质控组实施科室成立预防意外拔管前馈质量控制管理小组,制定前馈质量控制程序,加强人员培训、分析意外拔管的原因,确立前馈质量控制要点.结果 实行前馈质量控制管理的质控组与未实施前馈质量控制管理的常规组比较,质控组无1例发生气管插管（高危管道）意外拔管,与常规组6例气管插管（高危管道）意外拔管比较P＜ 0.01,两组发生意外拔管的情况,差异有统计学意义.结论 实施前馈质量控制管理能有效降低意外拔管的发生,提高护理质量管理的水平.

Objective To reduce the incidence of accidental extubation in ICU patients implementing feed-forward quality control management. Methods 232 patients not under feed-forward quality control management were selected into the routine group from January 2011 to January 2012. 457catheters were inserted in this group. 238 cases under feed-forward quality control management were selected into the quality control group from February 2012 to January 2013. 533 catheters were inserted in this group. In the quality control group, a feed-forward quality control team was formed in the department to prevent the accidental extubation. The jobs of the team were rulemaking procedures, strengthening staff training, analyzing the causes of accidental extubation, and establishing the essential of feed-forward quality control. Results No accidental extubation （high-risk extubation） occurred in the quality control group, while 6 cases accidentally extuhated the catheters in the routine group, with a statistical difference （P〈0.05）. Conclusions Feed-forward quality control management can effectively reduce the accidental extubation and improve the level of nursing quality management.