品管圈活动在口腔肿瘤术后口腔护理管理中的应用

Application of quality control circle on oral administration after oral cancer surgery

目的：探讨品管圈活动在口腔肿瘤术后口腔护理管理中的应用效果。方法成立品管圈活动小组,确立以“降低口腔肿瘤术后口腔感染发生率”为活动主题,进行现状调查,设立目标,从人、物、法3个方面查找原因,经过要因论证,确定主要因素,提出并落实有效的对策。选择2011年12月—2012年8月口腔肿瘤术后患者104例为活动前组,2012年9月—2013年5月口腔肿瘤术后患者107例为活动后组,通过自行设计的问卷调查患者的主观感觉、护士的评估和口腔分泌物细菌培养,比较实施前后患者口腔感染情况和护士操作技能改善情况。结果活动后口腔感染发生率为8.41%,活动前为18.27%,差异有统计学意义（χ^2=4.453,P〈0.05）；口腔肿瘤术后患者口腔舒适度高于活动前,差异有统计学意义（χ^2=47.766,P〈0.01）；活动后发生口臭11例,活动前为27例,差异有统计学意义（χ^2=8.783,P〈0.01）；品管圈活动后护士口腔护理理论考核与技能操作成绩分别为（93.07±3.55）,（94.27±3.58）分,高于活动前的（84.56±2.78）,（86.01±4.55）分,差异有统计学意义（t 值分别为-7.782,-5.882；P〈0.01）。结论品管圈活动为患者提供了清洁、舒适的口腔护理服务,提高了护士护理技能水平,降低了口腔炎症的发生。

Objective To discuss the effect of quality control circle activities in the oral administration process after oral cancer surgery. Methods The QCC was established and built up the theme of‘The decrease of the incidence of wound infection in the mouth after oral cancer surgery’ to investigate current status, set goals, and find the case from people, objects and rules. All information collected had been analyzed and demonstrated to confirm the main factors, and the corresponding measure was made out and implemented. A total of 104 oral cancer patients had been chosen before QCC establishment as control group during December 2011 to August 2012 while 107 oral cancer patients were as the experimental group after QCC establishment September 2012 to May 2013. We utilized self-designed questionnaire to explore patients′ subject feeling, nursing evaluation and oral secretion of bacteria culture, and compared the improvement of oral infection and nurse′s operation skill before and after measures implementation. Results The oral infection rate was 8. 41% in the experimental group comparing with 18. 27% of the control group （χ^2 =4. 453,P〈0. 05）, while oral comfort of experimental group was higher than that of control group after operation （χ^2 =47. 766,P〈0. 01）. Similarly, the kakostomia presented 7 cases before QCC establishment comparing with 11 cases after QCC establishment （χ^2 =8. 783,P〈0. 01）. After QCC activities, the assessment of nursing oral knowledge and practice skills acquired （93. 07 ± 3. 55）, （94. 27 ± 3. 58） scores higher than （84. 56 ± 2. 78）, （86. 01 ± 4. 55） scores before QCC activities （t= -7.782,-5.882;P 〈0. 01）. Conclusions The QCC activities can offer clean and comfortable oral nursing for the patients, improve the nursers′operations techniques, and reduce the possibility of oral inflammation.