消化内镜护理风险控制过程中应用PDCA的可行性

Feasibility of PDCA in the Nursing Risk Control under the Digestive Endoscopy

目的对消化内镜护理风险控制过程中应用PDCA的可行性和效果进行分析。方法以该院2010年1月—2017年1月在职的15名消化内镜科室的护理人员和6名消化内镜清洁人员为该次的研究对象。对2012年3月—2013年5月间该院消化内镜科室接诊的200例患者的临床资料进行回顾性分析。根据消化内镜护理过程中存在的问题制定并实施PDCA管理方案,比较实施前后消化内镜护理中人员的操作能力、患者护理满意度以及护理过程中出现不良事件的概率等。结果在实施了PDCA风险管理之后,消化内镜护理人员的工作职能(97.7±1.2)分、护理安全(98.5±0.7)分、内镜设备消毒灯等操作(95.7±2.1)分,评分情况较之前(92.3±2.0)分,(93.9±1.4)分,(88.7±3.1)分显著提高(t=9.132、9.872、6.341,P<0.05),患者对护理工作的满意度98.0%(196/200)和护理不良事件发生概率1.5%(3/200)较实施前84.0%(168/200)、2.5%(5/200)差异有统计学意义(P<0.05)。结论在消化内镜的护理工作中使用PDCA管理方案有效减少了护理不良事件发生,提高了患者护理满意度,保证了护理工作的质量。

Objective To analyze the feasibility and effect of PDCA in the nursing risk control under the digestive endoscopy. Methods 15 cases of on-the-job nursing staff in the digestive endoscopy room in our hospital and 6 cleaning staff in our hospital from January 2010 to January 2017 were selected, and the clinical data of 200 cases of patients in our hospital from March 2012 to May 2013 were reviewed, and the existing problems in the nursing course was made and PDCA management plan was implemented, and the operation ability, nursing satisfactory degree and occurrence probability of adverse events in the nursing course were compared before and after the implantation of digestive endoscopy. Results After the implantation of PDCA risk management, the work function, nursing safety and endoscope equipment disinfection lamp scores of nursing staff were obviously improved compared with those before implementation,（97.7 ±1.2）points,（98.5 ±0.7,）points,（95.7 ±2.1）points vs（92.3 ±2.0）points,（93.9 ±1.4）points,（88.7 ±3.1）points（t=9.132/9.872/6.341,P〈0.05）, and the differences in the satisfactory degree of patients to the nursing work and occurrence probability of nursing adverse events before and after implementation were obvious, the difference was statistically significant [98.0%（196/200）, 1.5%（3/200）, 84.0%（168/200）,2.5%（5/200）]（P〈0.05）. Conclusion The application of PDCA management plan in the nursing work of digestive endoscopy can effectively reduce the occurrence of nursing adverse events, improve the nursing satisfactory degree of patients and ensure the quality of nursing work.