四种质量管理工具在护理质量管理中的综合应用

Comprehensive application of four quality management tools in nursing quality management

目的分析护理质量管理工具综合应用成效及存在问题，提高护理质量，确保患者安全。方法总结计划-实施-检查-处理（PDCA）、品质管理圈（QCC）、根本原因分析、医疗照护失效模式与效应分析在护理质量改进中的实践。针对质量管理工具应用过程中的问题，采取系统培训质量管理知识、实例演示、规范项目的全程审核、开展竞赛活动、专家及时指导解惑等措施。结果PDCA、QCC项目共1798项，其中1795项其改善后监测结果达到项目前期科学制定的目标值，3项未达标项目经过再次原因分析、分解流程和调整主要改进内容后，最终达到预期改进效果。无护理事故及护理警讯事件发生，护理质量监控指标显著提高，患者满意度98．58％，位列全国第三。结论4种质量管理工具综合应用有利于提高护理质量的改进效果。

Objective To analyze the effect and the problems of the comprehensive application of quality management tools in order to improve nursing quality and ensure patient safety. Methods To summarize the implementation of Plan, Do, Check, Action （PDCA）, quality control circle （ QCC ）, root cause analysis（RCA）, healtheare failure mode and effect analysis （HFMEA） in the nursing quality improvement. Aiming at problems arising in application process, the measures such as systematic training of quality management knowledge, ease demonstration, standardized evaluation throughout the whole process, holding competition activities, inviting experts to give immediate guidance were applied. Results Among 1 798 PDCA and Qcc programs, the result of 1 795 programs reached the target value, 3 substandard programs reached the expected outcome finally after cause analysis, procedure break down and adjust of improvement contents. No nursing error or adverse events occurred. The indicators of nursing quality improved and patient satisfaction was 98.58%, which got the third position among all national hospitals. Conclusions The comprehensive application of four quality management tools was helpful in enhancing the effect of nursing quality improvement.