小儿静脉留置针穿刺质量持续改进的探讨

Discussion on the Continuous Quality Improvement of Pediatric Intravenous Indwelling Needle Puncture

目的探究持续质量改进(CQI)在小儿静脉留置针穿刺中临床效果、家长和护士满意度以及并发症状况,为临床小儿留置针穿刺提供指导意义。方法选用自2012年1月-8月来我院诊治的小儿患者351例作为对照组,采用常规护理,2013年4月-11月来我院诊治的小儿患者365例作为研究组,采用持续质量改进(CQI)护理,对比两组患者静脉留置针穿刺成功率、家长和护士满意度以及并发症发生状况。结果对照组静脉留置针穿刺一次性成功率为76.64%(269例),研究组静脉留置针穿刺一次性成功率为87.95%(321例),存在显著性差异(X2=15.776,P=0.000<0.01),两组之间家长和护士满意度存在显著性差异(X2=62.579,44.103,P=0.000,0.000<0.01),在留置针滑落、堵管、过敏性皮炎等并发症发生上,两者存在显著差异(P<0.01),在静脉炎、针眼感染、压疮等并发症发生上,两者无统计学差异(P>0.05)。结论持续质量改进护理管理在小儿静脉留置针穿刺中可以提高穿刺成功率以及家长和护士对护理结果满意度,并发症较低,效果显著。

Objective To explore the clinical effect of continuous quality improvement （CQI） in the indwelling needle puncture and parents＂ and nurses＂ satisfaction as well as complications, which could provide a guidance for clinical pediatric indwelling needle puncture. Methods Choose 351 pediatric patients cases who came to our hospital from 2012 January to August for diagnosis and treatment as the control group with routine nursing. Choose 365 pediatric patients who came to our hospital from 2013 April to November as the treatment group with continuous quality improvement （CQI） nursing. Compared the success rate of intravenous indwelling needle puncture and parents and nurses＂ satisfaction as web as complications between the two groups. Results In the control group, the one-time success rate of intravenous indwelling needle puncture was 76.64% （269 cases）, while that for the treatment was 87.95% （321 cases）. There was significant difference （X2=15.776, P=0.000〈0.01）, between the two groups. Parents＂ and nurses＂ satisfaction also had significant difference （X2=62.579,44.103, P=0.000,0.000〈0.01）. In terms of indwelfing needle slide, plugging, allergic dermatitis, there were no significantly statistical difference （P〈0.01）. In terms of phlebitis, phlebitis, pinhole infection, pressure sores and other complications, there were no significantly statistical difference （P〉0.05）. Conclusion Continuous quality improvement of nursing management on pediatric intravenous indwelling needle puncture could increase the success rate of puncture and parents＂ and nurses＂ satisfaction and reduce complications with remarkable effect.