持续质量改进模式在压疮高危患者中的应用

Application of FOCUS-PDCA program in nursing quality management of pressure ulcers

目的探讨持续质量改进模式(FOCUS-PDCA)在压疮高危患者中的应用效果。方法运用FOCUS-PDCA程序的发现、组织、澄清、理解、选择、计划、实施、检查和执行9个步骤分析患者发生压疮的原因,修改和完善压疮管理制度,对护理人员进行培训和实施压疮管理措施。了解实施FOCUS-PDCA程序进行压疮护理质量管理前后,患者压疮预防措施落实情况、护理人员压疮知识掌握情况和患者压疮发生情况。结果实施FOCUS-PDCA程序进行压疮护理质量管理后,患者压疮预防措施落实合格率、护理人员压疮知识掌握合格率高于管理前;患者压疮发生率低于管理前(均P<0.001)。结论运用FOCUS-PDCA程序对压疮高危患者实施压疮护理质量管理,能有效提高压疮预防措施的落实,提高护理人员的压疮护理知识,从而有效降低压疮的发生率。

Objective To investigate the effect of FOCUS-PDCA program on pressure ulcers nursing quality management.Methods By using the 9 steps of FOCUS-PDCA program of exploring, organizing, clarifying, understanding, selecting, planning,enforcing, checking and executing, we looked into the primarily factors for pressure ulcers and modified and improved our pressure ulcer nursing management system. Then training was done to the nurses, and the pressure ulcer management system was used. The effects in implementation of pressure ulcers prevention, mastery of pressure ulcers prevention knowledge among nurses and occurrence of pressure ulcers in the high-risk patients were studied after applying the program. Results After use of FOCUS-PDCA program, the qualification rate of pressure ulcers prevention implementation and mastery of pressure ulcers prevention knowledge were both higher than before the use. The occurrence rate of pressure ulcers in the high-risk patients was lower than before the use（ P 0.05）.Conclusion By using the FOCUS-PDCA program in the nursing quality management for patients with pressure ulcers, we can effectively improve the implementation of pressure ulcers preventive measures, enhance the nursing staff to master knowledge on pressure ulcers and reduce the incidence of pressure ulcers.