护理质量指标介导的精准质控模式在护理质量管理中的实施及效果评价

Implementation and effects assessment of precise quality control model mediated by nursing quality indexes in nursing quality management

目的 探讨由护理质量指标介导的精准质控模式在质量管理中的实施及效果.方法 选取2015年1—12月采用传统质控模式的57个护理单元为对照组;2016年1—12月采用精准质控模式的57个护理单元为干预组,方法包括选定指标数量和目标值、筛选质量监控点、统一指标采集路径、锁定影响质量的关键科室和监控点,开展质量管理绩效.观察两组质量指标的变化情况.结果 干预组与对照组比较,9个过程质量指标即病房6S管理、急救技术、健康教育、基础护理、一级和危重症患者护理、安全治疗、运行护理文书、药品和无菌物品效期和身份核查合格率,差异有统计学意义（P〈0.05）,5个结果质量指标即住院患者跌倒、给药缺陷、院内压疮、烫伤和尿管非计划拔管发生率,差异有统计学意义（P〈0.05）.结论 护理质量指标介导的精准质控模式,能提高护理工作质量,是实现质量持续改进的有效质控模式.

Objective To explore the implementation methods and effects of precise quality control model mediated by nursing quality indexes in quality management.Methods Fifty-seven care units with complete quality control data were collected. From January to December 2015, the 57 using the traditional quality control mode were selected as control group, whilst from January to December 201657 units were chosen for the intervention group using precision quality control mode, that was, to select the number of indicators and target values, screening quality control points, unified the acquisition path of indicators, lock the key departments and monitoring points affecting the quality to carry out quality management performance. We observed the changes of the two groups of quality indicators.Results The nine process quality indicators including wards 6S management, first aid techniques, health education, primary care, first class and critical care nursing, safe treatment, operating nursing documents,drug and sterile product quality and pass rate of identity verification were significant difference between the two groups（P〈0.05）. The five outcome quality indicators including hospitalized patients fall, dosing defects, hospital pressure sores, burns and urinary uncontrolled extubation rates were significant difference between the two groups（P〈0.05） as well.Conclusions The quality control model, which is mediated by the nursing quality index, is helpful to improve the nursing quality. It is an effective quality control mode to achieve continuous improvement of nursing quality.