PDCA在骨科术后预防深静脉栓塞管理中的应用

The Application of PDCA in Management to Prevent Deep Vein Thrombosis of Postoperative Orthopaedic Patients

目的探讨PDCA在骨科术后患者预防深静脉栓塞管理中的应用体会。方法构建患者术后深静脉栓塞管理模型，依据PDCA循环寻找出术后导致发生深静脉血栓的高危因素，制订适合本科室的护理指引，对实施持续质量改进后的患者深静脉栓塞管理效果进行评价。结果经过1年实施持续质量改进后，评估科室各层级护士对深静脉栓塞相关知识掌握程度由63%升至87%；下肢骨折术后患者深静脉栓塞的发生率由原来的4%降至0.5%，使患者对深静脉栓塞护理的总体满意度由原来的90%升为97%。结论对骨科患者深静脉栓塞管理进行持续质量改进，可有效防范风险，降低患者术后深静脉栓塞的发生，提高患者对护理的综合满意度。

Objective To discuss the application of PDCA in postoperative orthopaedic patients to prevent the deep vein embolism （DVT）. Methods We constructed the model of postoperative DVT, confirmed the risk factors of DVT based on PDCA, formulated nursing guideline and evaluated the management effects of postoperative DVT. Results After the one-year continuous quality improvement, the proportion of nurses who mastered the related knowledge of DVT increased from 63%to 87%, the morbidity of DVT decreased from 4%to 0.5%, the degree of satisfaction of nursing increased from 90%to 97%. Conclusion Continuous quality improvement on patients with deep vein thrombosis could prevent the occurrence of DVT effectively, and improve the satisfaction of nursing care from the patients.