运用品管圈降低ICU非计划性拔管发生率的效果分析

Effect analysis of application of quality control circle in reducing rate of non-planned decannulation in ICU

目的探讨品管圈对降低ICU非计划性拔管发生率的效果。方法成立品管圈活动小组,确定主题,制定目标,查找出现非计划性拔管的主要原因,针对原因制定相应改进措施。结果实施品管圈后ICU非计划性拔管发生率显著低于实施品管圈前(4.76%和21.43%),差异有统计学意义(P<0.05)。在拔管原因分析中,观察组患者自行拔管比例、意外滑脱比例显著高于对照组(P<0.05);对照组护理总满意率为81.0%,观察组护理总满意率为96.4%,观察组护理总满意率显著高于对照组(P<0.05)。对照组护理投诉发生率为19.0%,观察组护理投诉发生率为4.8%,观察组护理投诉发生率明显低于对照组(P<0.05)。两组实施前护士责任心、自信心、积极性、解决问题能力、团队凝聚力、沟通协调能力、幸福感评分均无统计学差异(P>0.05),实施后观察组各指标评分均显著高于对照组(P<0.05)。结论品管圈活动可显著降低ICU非计划性拔管发生率,并能提高圈员的综合能力。

Objective To explore effect of application of the quality control circle in reducing the rate of nonplanned decannulation in ICU. Methods Quality management circle activity group was set up to determine the theme and set goals to find the main causes for non-planned decannulation and formulate corresponding improvement measures. Results Rate of non-planned decannulation in ICU after the implementation of quality control circle was significantly lower than that before the implementation of quality control circle（4.76% and 21.43%）. The difference was significant（P〈 0.05）. In analysis of decannulation causes, self- decannulation rate and accidental slip rate of the observation group were significantly higher than those of the control group（P〈 0.05）. Total nursing satisfaction degrees of the control group and the observation group were 81.0% and 96.4% respectively. Total nursing satisfaction degree of the observation group was significantly higher than that of the control group（P〈 0.05）. Nursing complaint rate of the observation group was 4.8%, significantly lower than that of the e control group was 19.0%（P〈 0.05）. Before the implementation of quality control circle, sense of responsibility, self-confidence, enthusiasm, problemsolving skills, team cohesion, communication and coordination ability and the well-being scores of nurses in two groups had no significant difference（P〈 0.05）. After the implementation of quality control circle, all index scores of the observation group were all significantly higher than those of the control group（P〈 0.05）. Conclusion Quality management circle activity can significantly reduce the rate of non-planned decannulation in ICU and it can improve the comprehensive ability of circle members.