提高胸腔镜肺叶切除手术护理路径执行质量的品管圈实践

Application of quality control circle activity in improving the implementation quality of nursing pathways during thoracoscopic pulmonary lobectomy

目的探讨品管圈活动提高胸腔镜肺叶切除手术护理路径执行质量的效果。方法胸外科接受胸腔镜下肺叶切除手术患者475例为研究对象。其中2016年6月—12月收治的255患者为对照组,实施手术护理路径并常规监督管理;2017年1月—6月收治的220例患者为观察组,利用品管圈手法改进手术护理路径管理方法。对比2组护理路径执行质量优秀率,评估圈员品管圈能力。结果观察组护理路径执行质量评价优秀率较对照组提高(87.73%vs 65.10%),目标达成率109.50%,进步率64.84%。16名圈员品管圈手法、职业认同感、沟通协调能力、团队凝聚力评分指标均得到提高(P<0.05)。结论品管圈活动有效提高了胸腔镜肺叶切除手术护理路径的执行质量,提升护理质量及护士的综合素质。

Objective To investigate the effect of quality control circle（ QCC） activities in improving the quality of nursing pathways in thoracoscopic pulmonary lobecto my. Methods To tally 255 patients undergoing thoracoscopic pulmonary lobecto my between June,2016 and December,2016 were selected as the control group,and another 220 patients recruited between January,2017 and June,2017 were selected as the observation group. Both two groups were given clinical nursing pathways,and the QCC activities were carried out to regulate the implementation of clinical nursing pathway in the observation group. To compare the excellent rate of implementation between two groups,and to evaluate the QCC ability of nurses before and after QCC activities.Results The excellent rate of nursing pathway implementation was higher in the observation group than that of the control group（87. 73% vs 65. 10%）,with a target achievement rate of109. 50% and a progress rate of 64. 84%. The QCC ability,professional self-identificaito n,communication skills and teamcohesiveness of 16 QCC members were enhanced after implementation of QCC skills（ P〈0. 05）. Conclusion The implementation of QCC activity is potentially effective to improve the nursing quality during thoracoscopic pulmonary lobecto my,as well as comprehensive ability of nurses.