＂一病一品＂项目在妊娠期糖尿病患者中的实践效果

Practice effect of ＂disease-characteristics nursing quality improvement＂ program in patients with gestational diabetes mellitus

目的 探讨＂一病一品＂项目在妊娠期糖尿病患者中的实践效果.方法 采用方便抽样法选取妊娠期糖尿病患者841例为研究对象,按照＂一病一品＂项目实施前后分为两组,将2011年7月1日—2012年6月30日确诊的236例GDM患者设为对照组,2012年7月1日—2015年4月30日确诊的605例GDM患者设为干预组.对干预组实施以＂寻找最优的证据、依托最优的流程、体现最优的人文关怀＂为内涵的＂一病一品＂项目.比较两组研究对象的母儿结局、患者满意度、产科各护理单元护理质量评分.结果 两组巨大儿和妊娠期高血压疾病的发生率比较,差异无统计学意义（P〉0.05）;干预组的早产率（7.2%）低于对照组（16.0%）,差异有统计学意义（χ2=15.04,P〈0.01）.患者满意度的比较,除＂护士操作＂项目外,干预组其他各项得分均高于对照组,差异有统计学意义（P〈0.01）.＂一病一品＂项目实施前产科各护理单元护理质量专项检查综合得分均高于项目实施前,差异有统计学意义（P〈0.05）.结论 ＂一病一品＂项目可以降低GDM患者早产率,提高患者满意度,提升优质护理服务质量.

ObjectiveTo explore the practice effect of ＂disease-characteristics nursing quality improvement＂ program （DNQIP） in patients with gestational diabetes mellitus （GDM）.Methods Totally 841 GDM patients were selected by convenience sampling method and were divided into two groups based on whether they were nursed by the ＂DNQIP＂ program. Totally 236 GDM patients diagnosed between July 1st,2011 and June 30th,2012 were selected as the control group,while 605 GDM patients diagnosed from July 1st,2012 to April 30th,2015 were selected as the intervention group. Patients in the intervention group were cared with the ＂DNQIP＂ mode,which meant ＂looking for optimal evidence,relying on optimal processes and displaying optimal care＂. Finally,maternal and fetal outcomes,patient satisfaction and nursing quality ratings for various nursing units in two groups were compared.Results The differences in the incidence of macrosomia and hypertensive disorder complicating pregnancy between two groups were of no statistical significance （P〉0.05）;the incidence of premature delivery in the intervention group （7.2%） was significantly lower than that in the control group （16.0%） （χ2=15.04,P〈0.01）. In terms of patient satisfaction,the intervention group obtained higher scores than the control group in all items except for ＂nurses′ operation＂ （P〈0.01）. Composite score of special inspection for nursing quality of various nursing units after the implementation was higher than that before the implementation （P〈0.05）.Conclusions The DNQIP can reduce the incidence of premature delivery among GDM patients, improve the satisfaction of patients and optimize the quality of nursing service.