实施品管圈减少术前游离皮瓣移植患者供臂保护不良事件

Implementing quality control circle to reduce adverse events of preoperative donor arm protection of patients taken free flap transplantation

目的：探讨品管圈活动在口腔颌面部组织缺损修复所需的游离前臂皮瓣或腓骨肌皮瓣保护流程中的应用效果，减少皮瓣移植前不良事件的发生。方法：选择2011年5月-2013年8月口腔科患者24例为对照组，采用常规护理；选择2013年9月～2015年12月口腔科患者24例为观察组，成立品管圈活动小组，对皮瓣移植前护理流程、警示标识、培训计划及内容等护理问题进行分析并查找原因，积极制定改进措施，比较两组患者供臂保护不良事件发生率及护理质量满意度。结果：观察组患者皮瓣保护不良事件发生率低于对照组（P〈0．05），护理质量满意度高于对照组（P〈0．05）。全体圈员自我能力明显提升。结论：实施品管圈活动可有效减少皮瓣保护不良事件的发生，提高护士工作积极性及管理意识。

Objective ： To explore the application effect of quality control circle activities in protection flow of free forearm flap or fibula flap needed in reeonstruction of tissue defect at oral and maxillofacial region, and reduce the occurrence of adverse events before flap transplantation. Methods ： Selected 24 patients in stomatology department from May 2011 to August 2013 as control group, and gave them routine nursing; selected 24 patients in stomatology department from September 2013 to December 2015 as observation group, established quality control circle activity group, analyzed the nursing problems of nursing flow before flap transplantation, warning sign, training plan and content and searched for reasons, positively made improvement measures, compared incidence of adverse event of donor arm protection and nursing quality satisfaction of patients in the two groups. Results ： The incidence of adverse event of flap protection of patients in the observation group was lower than that of the control group （ P 〈 0. 05 ）, and the nursing quality satisfaction was higher than that of the control group （ P 〈 0.05 ）. The self - competence of all the quality control circle members significantly improved. Conclusion ： Implementing quality control circle activities can effectively reduce the occurrence of adverse event of flap protection, and improve nurses＇ working enthusiasm and management consciousness.