闭环管理对基层医院静脉治疗质量管理效果的影响

Effects of closed loop management on quality management of intravenous therapy in primary hospital

目的探讨闭环管理对基层医院静脉治疗质量管理效果的影响。方法选取2015年3月—2016年3月接受静脉治疗的444例有效输液患者为研究对象。按实施闭环管理的时间分组,其中2015年3月—2015年9月的214名患者为常规组,采用常规管理模式;2015年9月—2016年3月的230名患者为实验组,实施闭环管理模式。统计2组治疗有效率、输液钢针使用率、关节穿刺率、导管维护金标准践行率、敷贴固定规范率、输液相关并发症率、用药错误率、意外事件发生率、漏报病例率。结果常规组患者静脉治疗有效率166例(77.8%),实验组197例(85.7%),差异有统计学意义(P<0.01)。实验组输液钢针使用率和关节穿刺率低于常规组,导管维护金标准践行率和敷贴固定规范率高于常规组,差异有统计学意义(P<0.05或P<0.01)。实验组输液相关并发症率、用药错误率、不良事件发生率和漏报病历率低于常规组患者,差异有统计学意义(P<0.05)。结论闭环管理对基层医院静脉治疗质量管理效果有着积极影响,通过反馈机制能增强信息流通率,降低护理不良事件的发生率。

Objective To investigate the effect of closed loop management on the quality management of intravenous therapy in primary hospital. Methods A total of 444 cases of patients were selected as the research object from March 2015 to March 2016, in which 214 patients were se-lected as the conventional group from March 2015 to September 2015 and another 230 patients from September 2015 to March 2016 were selected as the study group. Since September 2015 the implemen-tation of closed-loop management was carried out in the study group. The treatment efficiency, infusion needle usage, joint puncture rate, catheter maintenance by gold standard practice, standardized appli-cator fixed, transfusion related complications, medication errors, nursing adverse events and missing report of medical record were compared between two groups. Results The efficacy of intravenous therapy was 166（77. 8% ） in the control group and was 197 cases （85. 7% ） in the study group, with a significant difference（P 〈 0. 01） . The usage rate of steel needle and joint puncture rate was lower in the study group than that in the control group （P〈0.05 orP〈0.01） . The rate in standard applicator fixed and catheter maintenance by gold standard was higher in the study group than that of controls. Respectively （P〈0.05 orP〈0.01） . The incidence of catheter-related complications, dedication er-ror ,nursing adverse events and missing report of medical record was lower in the study group than that of controls respectively （ P 〈 0. 05 ） . Conclusion Closed loop management has a positive impact on the quality management of intravenous treatment in the primary hospital, through the feedback mecha-nism can enhance the information flow rate, reduce the incidence of nursing adverse events.