精益管理提升住院患儿放射学检查镇静效率的实践与效果

Improving efficacy of sedation procedure during radiology in inpatient pediatric patients with lean management

目的:降低血液肿瘤科住院患儿放射学检查镇静失败率,提高护理工作效率。方法:成立精益西格玛小组,基于精益管理DMAIC法,明确住院患儿放射学检查镇静中的问题,通过价值流程图、鱼骨图、调查法等方法找到关键问题,结合最新最佳证据,优化镇静用药及检查流程、更新镇静禁食及用药方案、完善宣教内容和途径,并对改进效果进行评价。结果:改进后住院患儿放射学检查镇静失败率、平均护理时长均优于目标值,与改进前相比差异有统计学意义(P<0.05)。结论:基于精益管理的优化改善,可提高放射学检查镇静的工作效率,有利于医院整体资源更高效运行。

Objective： To decrease the failure rate of sedation procedure during radiology and increase the efficacy of nursing. Methods： After establishment of a Lean Management team, we referred to DMAIC process, verified the possible defects related to sedation procedure during radiology for inpatient pediatric patients, and found the key problem through value stream, fish bone analysis, investigation. Finally we integrated the best available evidences into routine process of sedation medication administration and radiology, improved the fasting and medicine administration instruction, renewed and standardized the related health education, and evaluated the improvement results through data. Results： After this quality improvement project, the failure rate and average nursing time for every case of sedation procedure during radiology decreased significantly than before （P〈0.05）. Conclusion： Lean Management could increase efficacy of sedation procedure during radiology in inpatient pediatric patients and facilitate the effective running of hospital resources.