基于JCI理念的质量管理对护理敏感质量指标的影响

The Influence of Quality Management on Sensitive Quality Index of Nursing Based on JCI Concept

目的探讨基于JCI标准理念的护理质量管理对护理人员及住院患者护理敏感质量指标的影响。方法 2015年3月—2016年2月在医院进行住院治疗的患者39 871例次、护士710例作为对照组;2016年3月—2017年3月在医院进行住院治疗的患者42 873例次、护士782例作为观察组。对照组采取医院常规护理质量管理,观察组实施基于JCI标准理念的护理质量管理,对比两组护理敏感质量指标水平的差异。结果观察组中床护比、护士离职率低于对照组,护患比、每住院患者24 h平均护理时数高于对照组;住院患者跌倒发生率、院内压疮发生率、住院患者身体约束率、插管患者非计划拔管发生率低于对照组;ICU导尿管相关尿路感染发生率、ICU中心导管相关血流感染率、ICU呼吸机相关性肺炎发生率均低于对照组,差异具有统计学意义(P<0.05)。结论基于JCI标准理念的护理质量管理,可有效缓解护理人员工作负荷并减少人员流失,降低普通病房患者的意外事件发生率、ICU患者的感染性事件发生率。

Objective To explore the influence of Nursing quality management underwent JCI standard concept on nursing sensitive quality index of Nurses and inpatients. Methods 39 871 cases of hospitalized patients, 710 cases of nurses in our hospital from March 2015 to February 2016 were chosen as control group, 42 873 cases of hospitalized patients, 782 cases of nurses from March 2016 to March 2017 were chosen as observation group. The control group underwent routine nursing quality management, those in observation group were treated with nursing quality management based on the JCI standard concept, nursing sensitive quality indicators were compared between two groups. Results Nursing bed ratio, nurse turnover rate in observation group were lower than those in control group, nurse patient ratio, 24 patients per hour average nursing hours in observation group were higher than those in control group; incidences of inpatients fall in hospital, pressure ulcers, hospitalized patients physical restraint, unplanned extubation rate in observation group were lower than those in control group; ICU catheter associated urinary tract infection, ICU central catheter related bloodstream infection rate, ICU ventilator-associated pneumonia rate in observation group were lower than those in control group, the difference was statistically significant（P〈0.05）. Conclusion Nursing quality management standards bases on the concept of JCI, can effectively alleviate the workload of nursing staff and reduce staff turnover, reduce accidents in general ward patients the incidence of ICU infection in patients with event rate.