课题达成型品管圈活动在构建以家庭为中心的早产儿护理模式中的应用

Application of quality control circle with project achievement style in the construction of family-centered care for premature infants

目的 探讨课题达成型品管圈在创建以家庭为中心的早产儿护理模式中的应用,为以家庭为中心的护理模式提供理论支持。 方法 成立品管圈小组,选定"创建以家庭为中心的早产儿护理模式"为活动主题,按照课题达成型品管圈的活动步骤开展活动,通过调查医护人员的支持度,家属的需求,专职护士对家属进行培训和考核,运用失效模式与效应分析预防医院感染的发生以及三位一体共同制定出院计划等措施来推进活动的进行。评价活动前后有形成果和无形成果。 结果 品管圈活动后我科早产儿的体质量增长速度、住院天数、家属照顾能力评分、母乳喂养率、家属满意度分别为(18.92 ± 0.66)g·kg^-1·d^-1、(23.28 ± 1.39)d、(98.10 ± 12.57)分、47.25%(69/146)、96.58%(141/146);品管圈活动前分别为(17.26 ± 0.38)g·kg^-1d^-1、(26.40 ± 1.10)d、(61.45 ± 15.07)分、13.45%(16/119)、80.67%(96/119),2组比较差异有统计学意义(t=7.31、5.89、7.52,χ^2=34.41、17.55,P<0.01);品管圈活动前后医院感染发生率分别为(6.11 ± 3.59)%、(5.61 ± 2.19)%,两者比较差异无统计学意义(χ^2=0.26,P>0.05)。此外,多家医院前来参观学习,收获了经济、社会效益。 结论 以家庭为中心的早产儿护理模式有利于早产儿护理质量的提高,课题达成型品管圈活动有助于提高科室全体医护人员对该模式的参与度和接受度,为以家庭为中心的护理模式的推行提供基础。

Objective To discuss the application of quality control circle with project achievement style in the construction of family-centered care for premature infants. Provide theoretical support for family-centered care model. Methods Set up quality control circle group, select the topic as "construct a family-centered care for premature infants". Carry out activities according to the activity steps of the quality control circle with project achievement style. Advance activities by looking at the support of health care workers, family needs, carrying on the training and the examination to the family member, using the Failure Mode and Effect Analysis (FMEA) to prevent hospital infection and developing discharge plan by trinity model. Then evaluation of tangible and intangible results before and after the activity. Results The growth rate of body mass, breast-feeding rate, length of stay, family satisfaction and family care ability of premature infants after the quality control circle activities were respectively as follow (18.92±0.66) g/kg/d, 47.25%, (23.28±1.39) d, 96.58%, (98.10±12.57) points;before the quality control circle activities all the scores were respectively as follow (17.26±0.38) g/kg/d, 13.45%, (26.40±1.098)d, 80.67%, (61.45±15.07) points. The difference between the two groups was statistically significant (t=7.31, 5.89, 7.52, χ^2=34.41, 17.55, P<0.01) . The incidence of hospital infection before and after quality control circle activities were respectively (6.11±3.59)%, (5.61±2.19)%, the difference was not statistically significant (χ^2=0.262, P>0.05) . In addition, we also gained economic and social benefits and many hospitals came to visit and study family-centered care model. Conclusion The family-centered care model is beneficial to the improvement of the nursing quality of premature infants. The activities of the Quality Control Circle with project achievement style can help to improve the participation and acceptance of all medical staff in this model and provide a foundation for the implementation of family-centered care model.