PDCA管理模式对护士的分诊能力及患者满意度的影响

Influence of PDCA management model on the individual diagnosis capacity of nurses and patient satisfaction

目的 研究PDCA管理模式在急诊分诊质量管理中的应用效果,包括对护士分诊能力及患者满意度的影响.方法 由某三级甲等医院急诊科的12名主管护师组成PDCA管理小组,以2014年7-12月急诊接诊患者的护理程序为调查对象,此时间段内的患者按照常规的就诊流程就诊,PDCA管理小组成员对此时间段内相关的急诊、急救护理质量进行现状调查,找出目前急诊科存在的护理质量问题,针对问题进一步分析原因、制定计划、改进措施、实施方案,定时监控、检查,持续质量改进.对经PDCA管理之后的2015年4-9月急诊接诊患者的护理程序再次进行统计调查,比较改善前和改善后对应的指标,包括急诊分诊准确率和患者的护理满意度.结果 将改善前和改善后的急诊分诊准确率进行比较分析,改善前和改善后分别为89.1%和95.3%,采用χ2检验,差异有统计学意义（P〈0.05）.将改善前和改善后患者的护理满意度进行比较,分别为84.4%和93.4%,两组进行χ2检验,差异有统计学意义（P〈0.05）.结论 PDCA管理模式的实施,可显著提高护士的分诊能力,提高急诊分诊准确率及患者的护理满意度,提高急诊分诊的管理质量.PDCA管理模式可被用作护理管理层简单可靠的质控管理工具.

Objective To study the application effect of PDCA management model on emergency and individ-ual diagnosis quality management, including the influence on the individual diagnosis capacity of nurses and patient sat-isfaction. Methods The PDCA management team consisting of 12 chief nurses from a certain grade-A class-3 hospital regarded the nursing process of received emergent patients from July to December, 2014 as the respondent. In this peri-od of time, the patients went to see the doctor according to the regular treatment procedure. PDCA management team members had investigation about the related emergency and emergency care in this period to find out the potential nursing quality problem in emergency department so as to further analyze the cause, make plan, improve measures, implement scheme, timely monitor, check and continuously improve the quality aimed at the problem. Moreover, statistical in-vestigation was conducted to the nursing procedure of patients received in the emergency department from April to Sep-tember, 2015 again to compare the index before and after improvement, including the individual diagnosis precision in the emergency department and patients＇ nursing satisfaction. Results The individual diagnosis precision in emergency department was compared and analyzed before and after improvement. The precision was 89. 1% and 95. 3% before and after improvement. χ2 examination was used, and the difference had statistical significance （ P〈0. 05 ） . The nursing satisfaction of patients before and after improvement was compared, which was 84. 4% and 93. 4%. χ2 examination was conducted to both groups, and the difference had statistical significance （ P〈0. 05 ） . Conclusions The implementa-tion of PDCA management model can significantly improve the individual diagnosis capacity of nurses, improve the indi-vidual diagnosis precision of emergency department and nursing satisfaction and improve the management quality of indi-vidual diagnosis of emergency. PDCA management model can be used as a simple and reliable quality control manage-ment tool for the nursing management level.