运用品管圈活动提高患者床头抬高依从率

Quality control circle activities to improve patients' compliance to head-ofbed elevation

目的探讨实施品管圈活动(QCC)对护理人员呼吸机相关肺炎(VAP)相关知识掌握情况、患者床头抬高依从性及VAP发生率的影响。方法采用随机抽样的方法,抽取某院重症监护室(ICU)使用呼吸机患者100例,其中实施QCC前(2013年1—6月)和实施QCC后(2013年7—12月)各50例。对实施QCC前后ICU护理人员、使用呼吸机患者进行调查。结果实施QCC后,护理人员对VAP发生原因、危害,以及患者床头抬高意义、标准,确定床头抬高≥30°相关知识的评分均高于实施QCC前;总评分为(18.32±3.14)分,高于实施QCC前的(7.98±1.12)分,差异均有统计学意义(均P<0.05)。实施QCC后,患者床头抬高依从率为96.00%(48例),高于实施QCC前的44.00%(22例);VAP发生率为4.00%(2例),低于实施QCC前的36.00%(18例),差异均有统计学意义(均P<0.05)。结论开展QCC活动能有效提高ICU护理人员VAP相关知识水平和患者床头抬高依从率,降低患者VAP发生率,有利于提高ICU医院感染管理质量。

Objective To evaluate the effect of implementing quality control circle （QCC）activities on nurses’ knowledge about ventilator-associated infection（VAP）,as well as head-of-bed （HOB）elevation and incidence of VAP in patients.Methods 100 patients who used ventilators in an intensive care unit（ICU）of a hospital were ran-domly selected,50 patients were selected before the implementation of QCC（January-June,2013）,and 50 were se-lected after the implementation of QCC （July-December,2103）.Condition of nurses and patients who used ventila-tors before and after implementation of QCC were investigated.Results After implementing QCC,the scores of nurses’recognition on knowledge about causes and risks of VAP,significance and standard of HOB elevation,and HOB elevation≥ 30°were all higher than before implementing QCC;the total score was higher than before imple-menting QCC （[18.32±3.14]vs [7.98 ±1 .12],P 〈0.05 ）;patients’compliance to HOB elevation was higher than before implementing QCC（[96.00%,n=48]vs [44.00%,n=22],P 〈0.05）;incidence of VAP was lower than before implementing QCC （[4.00%,n =2]vs [36.00%,n =18],P 〈0.05）.Conclusion Implementation of QCC activities can effectively improve ICU nurses’recognition on knowledge about VAP and enhance patients’ compliance to HOB elevation,as well as reduce the incidence of VAP,it is helpful for improving healthcare-associat-ed infection management quality.