＂一病一品＂项目在腹膜透析相关腹膜炎护理中的应用效果

Application of ＂disease-characteristics nursing quality improvement＂ program in the nursing of peritonitis-related peritoneal dialysis

目的 通过对患者实施腹膜透析相关腹膜炎＂一病一品＂项目,降低腹膜炎发生率.方法 由专项管理小组在2011年制定腹膜透析相关腹膜炎＂一病一品＂项目,对2012—2015年长期随访的腹膜透析患者实施该项目的持续质量改进,计算年均腹膜炎发生率,评价项目实施前后专项小组护士在和谐程度、积极性、责任感、沟通度、愉悦感、凝聚力、解决问题能力和工作负担8个方面的工作能力.结果 腹膜透析中心2012—2015年腹膜炎发生率分别为64.38、66.43、73.13、84.97病人月.护士能力自评结果显示,2012年解决问题能力（3.75±0.50）分,2015年（4.75±0.50）分,差异有统计学意义（P〈0.05）,其他方面差异无统计学意义（P〉0.05）.护士修订腹膜炎临床护理常规2项.结论 腹膜透析相关腹膜炎＂一病一品＂项目可以促进持续降低腹膜炎总体发生率,提高护士解决问题能力,促进临床护理常规更新.

Objective To reduce the incidence rate of peritonitis by using ＂disease-characteristics nursing quality improvement＂ program（DNQIP）of peritonitis-related peritoneal dialysis.Methods A specialized administration group drew up a blueprint of DNQIP on peritonitis-related peritoneal dialysis in 2011. Continuing quality improvement was given to long-term followed-up patients from 2012 to 2015,and the incidence rate of peritonitis was calculated. Harmony degree,initiative,sense of responsibility,communication ability,emotion,team spirit,competence in dealing issues,and work load of specialized nurses before and after the implementation of project were evaluated.Results The incidence rates of peritonitis were 64.38,66.43, 73.13,and 84.97 patient/month in 2012,2013,2014,and 2015. Nurses self-evaluation results showed that the score of competence in dealing issues in 2012 was（3.75±0.50）,the score had risen in 2015（4.75±0.50） （P=0.046）. The difference in other aspects was not significant（P〉0.05）.Conclusions DNQIP in peritonitis-related peritoneal dialysis is effective in reducing general incidence rate of peritonitis,and improving the competence of dealing issues for nurses and promoting the regular update of clinical nursing.