胰岛素笔注射技能合格率问卷的建立及对持续质量改进的效果评价

Establishment of qualified rate for insulin pen injection skills and evaluation of continuous quality improvement

目的探讨胰岛素笔注射技能合格率问卷的建立及其对持续改善护理质量的效果。方法通过对2016年1月至12月苏州大学附属第一医院内分泌科糖尿病患者胰岛素笔注射技能掌握不佳原因的分析,设计胰岛素笔注射技能合格率问卷作为专科护理质量监测工具和质量控制标准。在实施过程中,定期数据分析和持续质量改进。采用问卷评分方式对注射相关的护理缺陷和住院满意度进行质量改进前后效果评价。结果 2017年4月至12月共抽查85例患者,其中第2季度29例,第3、第4季度56例。胰岛素笔注射技能问卷平均得分(90.5±9.5)分,合格率100%;分项得分结果显示,进行质量改进后(第3、第4季度),问卷中的第4、第5、第9、第10条目得分明显提高,与第2季度比较差异具有统计学意义(P<0.05)。发生胰岛素注射技能指导缺陷例数为0,电话随访患者住院满意度99%。结论以胰岛素笔注射技能合格率问卷作为专科监测评估工具,促进护理质量持续改进,可以减少护理缺陷,提升患者的注射技能,提高住院满意度。

Objective The aim of this study is to evaluate the newly established index which is thequalified rate for insulin pen injection skills. Methods By analyzing poorly-controlled insulin pen injection skillof inpatients in the previous year, the qualified rate and questionnaire of insulin injection skills were establishedas monitoring indicators and quality control standards. In the implementation process, regular data analysis andcontinuous quality improvement were performed. Questionnaire scores, injection-related nursing deficiencies, andin-hospital satisfaction were used to evaluate the effects before and after quality improvement.Results A total of85 patients were sampled from April to December 2017, including 29 cases in the second quarter and 56 cases inthe third and fourth quarters of the year. Average score of Insulin Pen Injection Skills questionnaire were （90.5±9.5） points with pass rate reaching 100%. Questionnaire items 4, 5, 9 and 10 scored significantly improved afterquality improvement （third and fourth quarter）, compared with the second quarter. The difference was statisticallysignificant （P〈0.05）. The number of injection-related nursing deficiencies was 0 and the in＇hospital satisfactionwas 99%. Conclusions Using the insulin pen injection skill qualification rate questionnaire as a specialistmonitoring indicator and assessment tool, we could improve the patient＇s injection skills and hospitalizationsatisfaction.