运用科学管理缩短急性脑梗死rt—PA静脉溶栓患者DNT的研究

目的探讨科学管理缩短急性脑梗死重组组织型纤溶酶原激活剂（rt—PA）静脉溶栓患者到达急诊室至静脉滴注rt—PA药物时间（DNT）的效果。方法组建科学管理小组，通过科学管理的步骤及方法，对影响溶栓流程中的关键问题进行分析，制定目标和对策，对策实施后进行效果评价。结果使用科学管理的方法有效优化了溶栓流程，使急性脑梗死静脉溶栓患者DNT由120min缩短为60min（U=11．5，P=0．03），DNT〈60min患者的比例从0％提高至50％（P=0．02），同时提高了组员的工作能力和管理意识。结论应用科学管理可制定规范且有效的急性脑梗死患者溶栓流程，缩短急性脑梗死患者急诊静脉溶栓DNT时间，提高团队的协作精神及工作积极性。

Objective To explore the effect of quality control circle to shorten the door-to-needle time （ DNT ） of thrombolytic therapy for patients with acute cerebral infarction （ ACI ） . Methods A quality control circle group was established and key factors in thrombolytic therapy were identified then the were put forward and its effects were assessed. Results Quality control circle was effective for the process optimization of thrombolytic therapy and patients＇ DNT was shortened from 120 min to 60 min （ U=I 1.5, P=-0.03 ） . The proportion of patients with DNT≤60 minutes was increased from 0% to 50% （ P=0.02 ） . At the same time, it also improved the working ability and management consciousness of the circle members. Conclusions Quality control circle is effective for the process optimization of thrombolytic therapy and shortens the DNT of thrombolytic therapy and improves their members＇ cooperation consciousness and working enthusiasm.