持续质量改进在手术室防止患者术中低体温的效果观察

the Effects Observed of Continuous Quality Improvement in the Operating Room to Prevent in Patients with Intraoperative Hypothermia

目的探讨持续质量改进(CQI)在手术室防止患者术中低体温的应用效果。方法选择2013年3月至2014年3月期间在我院接受手术治疗的患者112例,根据其接受护理的方式分为CQI组和常规组两组,CQI组应用持续质量改进方法,术前进行低体温危险因素评估,制定相应的护理流程,术中对易发生低体温的患者实施针对性的预防措施,术后对患者出现术中低体温的现状、原因进行分析,并对改进结果进行系统客观评价。常规组采用常规护理方法,比较两组患者术中低体温的发生率。结果经分析可知患者自身因素、年龄因素、术中应用麻醉药物、手术室温度过低、输液输血等原因均可造成手术室患者术中低体温;术毕时两组患者体温均较术前有所下降,且CQI组与术前相比差异有统计学意义(P<0.05);CQI组在手术进行15、30、60 min及术毕时体温均较常规组高,差异有统计学意义(P<0.05)。CQI组有6例术中出现低体温,低体温发生率为10.72%,常规组出现19例,低体温发生率为33.93%,两组低体温发生率差异有统计学意义(P<0.05)。结论应用持续质量改进方法可以有效预防手术室内患者术中发生低体温情况。

Objective To investigate the continuous quality improvement（CQI） technique in the application effect of low temperature to prevent patients in the operating room. Methods in March, 2013- March 2013 in our hospital during the surgery treatment of 112 cases of patients, according to the accept care into the CQI group and routine group two groups, the CQI group by the method of continuous quality improvement, preoperative risk factors for low temperature evaluation, formulate corresponding nursing process, patients with intraoperative hypothermia for easy happened corresponding prevention measures, the present situation of low temperature, and the problems of patients after reason is analyzed, and the improved results are objective evaluation system. The conventional nursing methods conventional group, compared two groups of patients in the incidence of low body temperature. Results Through the analysis on the patient＇s own factors, age, intraoperative application of narcotic drugs, operating room temperature is too low, transfusion of blood transfusion of surgery in patients with middle and lower body temperature can cause the operating room; Finish operation temperature are two groups of patients when compared with preoperative declined, and CQI group compared with the preoperative difference was statistically significant（P〈0.05）; CQI group in surgery for 15 min, 30 min, 60 min and finish at high temperature than the conventional group, the difference was statistically significant（P〈0.05）. CQI group of six cases of intraoperative hypothermia, 10.72% incidence of low body temperature, conventional group（19 cases）, the incidence of low body temperature was 33.93%, the incidence of low body temperature differences between the two groups was statistically significant（P〈0.05）. Conclusion The application of continuous quality improvement method can effectively prevent indoor surgery patients intraoperatie hypothermia happens.