品管圈活动在重度创伤性颅脑损伤患者气管切开术后护理中的应用

Effect of nursing intervention by quality control circle activities on tracheostomy after severe traumatic brain injury

目的肺部感染是重症颅脑损伤患者的常见并发症,严重影响患者的预后。在治疗时不仅要积极改善患者病情,还要采取科学的措施降低肺部感染发生率。本文利用品管圈(QCC)活动以探讨重度颅脑损伤患者气管切开术后的护理价值。方法分析2015年11月—2016年4月六安市中医院收治的40例重度颅脑损伤气管切开术后发生肺部感染的患者作为对照组进行探讨、设定目标值及制定可行性整改措施,与2016年5—10月开展QCC活动后的36例气管切开患者的感染率进行比较。在肺部感染的患者中,对2组的抗生素使用时间及发热持续时间进行比较。结果在对照组中,有34例患者出现肺部感染,感染率为85.00%。与对照组相比,QCC活动组中的肺部感染有19例,占52.78%,2组相比差异具有统计学意义(χ~2=9.321,P<0.05),在2组肺部感染的患者中,QCC活动组的抗生素使用时间及发热持续时间较对照组均显著降低(P<0.05)。结论 QCC活动不仅降低了重度颅脑损伤患者气管切开后的肺部感染率,使肺部感染得到有效控制,控制时间缩短,而且为提高重症患者的护理质量提供理论依据,该种措施值得在临床中推广和使用。

Objective Pulmonary infection is a common complication in patients with severe traumatic brain injury,which seriously affects the prognosis of patients. Not only do we need to improve the patient＇ s condition , but also to take scientific measures to reduce the incidence of pulmonary infection. The paper supplies control circle（QCC） activities to explore the value of nursing care after tracheostomy in patients with severe craniocerebral injury. Methods Quality control circle activity was set up and the activity theme was established in 36 patients with tracheostomy after the injury and 40 subjects serving as control group. Pneumonia rate was compared between QCC activities group and control group. Time of antibiotic use and duration of fever in patients with pneumonia were also compared after the injury between two groups. Results In the control group,including 34 cases of patients with pulmonary infection, infection rate was 85%. There were 19 cases of pulmonary infection in QCC group, accounting for 52.78%, which was statistically significant compared with the control group （ χ2 = 9.321, P = 0. 002, P 〈 0.05 ）. For patients with pneumonia, the QCC activities significantly shortened the time of antibiotic use and duration of fever（P 〈 0.05）. Conclusion The results indicated that Qcc activity not only reduced the incidence of pneumonia after trachenstomy and pulmonary infection which was effectively controlled, but also may be helpful for improving the skills as a quality management tool, thus worthy of promotion and use in clinical practice.