品管圈活动降低神经内科留置胃管患者非计划性拔管率的效果观察

Application of QCC in reducing unplanned decannulation rate in Neurology patients with indwelling gastric tube

目的：探讨品管圈（ QCC）活动在降低神经内科留置胃管患者非计划性拔管率中的应用效果。方法成立品管圈活动小组,确定圈名,运用头脑风暴法确立“降低神经内科留置胃管患者非计划性拔管率”为活动主题,运用PDCA循环手法分析影响神经内科留置胃管患者非计划性拔管率的原因,进行统计、分析,查找真因,制定改进对策,组织落实。对活动开展前后的有形与无形成果进行比较。结果品管圈活动后,留置胃管患者非计划拔管率为7.8％（4/51）,低于活动前拔管率22.2％（10/45）,差异有统计学意义（χ^2＝3.97,P＝0.046）,超过目标值12％,达标率为144％,进步率为64.9％。结论品管圈活动规范了留置胃管的护理方法,促进了排班模式的更新,提升了护士综合素质,促进了护理品质的持续改善。

Objective To explore the efficacy of quality control circle （ QCC ） in reducing unplanned decannulation rate in neurology patients with indwelling gastric tube. Methods We set up a team of QCC and identified the activity theme as“reducing the rate of unplanned extubation for patients in neurological department with indwelling gastric tube” by brainstorming method. PDCA cycle technique was used to analyze various reasons that influenced the unplanned extubation rate of patients. We made statistics and analysis to find true cause, improve measures and organize implementation. The results were compared before and after the program. Results After the program of QCC, the decannulation rate was 7.8% （4/51）, and was 22.2% （10/45） before＆amp;nbsp;the program of QCC （χ^2=3.97, P=0.046）;exceeded target value 12%;the control rates was 144%, and the progress rate was 64. 9%. Conclusions Application of QCC program can standardize nursing methods of indwelling gastric tube;promote the scheduling model updating; enhance the comprehensive quality of nurses, and promote continuous improvement of quality.