PDCA循环管理在降低儿科静脉留置针堵管发生率的应用研究

Application of PDCA cycle management in reducing the incidence of needle occlusion in pediatric venous indwelling

目的探讨PDCA循环管理在降低儿科静脉留置针堵管发生率的应用效果。方法选择2015年10月至2017年10月间,在平凉市崆峒区妇幼保健院及平凉市第二人民医院接受输液治疗并使用外周静脉留置针的患儿164例,以2015年10月至2016年9月未实施PDCA循环管理之前的82例为对照组,以2016年10月至2017年10月,实施PDCA循环管理后接受治疗的82例为研究组,比较两组外周静脉留置时间,堵管及并发症发生率,患儿家属满意度。结果实施PDCA循环管理的研究组静脉留置时间较对照组相比明显延长(P<0.05),同时研究组非计划撤管发生率明显低于对照组(P<0.05)。研究组患儿静脉留置堵管、外渗发生率明显低于对照组(P<0.05),同时研究组未出现穿刺点皮肤感染及静脉炎。研究组患儿家属满意度为73.17%,明显高于对照组(40.24%,P<0.05)。研究组静脉留置规范操作考核通过率为92.56%,明显高于对照组66.67%(χ~2=0.017,P<0.05)。结论采用PDCA循环管理通过强化静脉留置操作技能;加强冲管封管的培训,优化对患儿家属的健康宣教等干预措施,可有效降低患儿静脉留置堵管及外渗发生率,改善患儿家属的满意度。

Objective To investigate the application of PDCA cycle management in reducing the incidence of needle occlusion in pediatric venous indwelling. Methods Selected 164 cases of Children patients were treated by infusion therapy and using of peripheral venous indwelling needle in Maternal and Child Health Care in Pingliang Kongtong District and Pingliang second people s Hospital, from October 2015 to October 2017. From October 2015 to September 2016, 82 cases without PDCA cycle management were considered as the control group, and The study group consisted of 82 patients who received treatment after PDCA cycle management from October 2016 to October 2017. Results Compared with the control group, the intravenous indwelling time of the study group with PDCA cycle management was significantly longer than that of the control group（ P 〈0.05）. At the same time, the incidence of unplanned withdrawal in the study group was significantly lower than that in the control group （ P 〈0.05）. The incidence of extravasation in the study group was significantly lower than that in the control group （ P 〈0.05）, and there was no skin infection and phlebitis at the puncture point in the study group. The satisfaction of the families of the children in the study group was 73.17 % significantly higher than that of the control group （40.24 % , P 〈0.05）. The pass rate of the standard operation of venous indwelling in the study group was 92.56 % , which was significantly higher than that in the control group （66.67 % , χ 2 =0.017, P 〈0.05）. Conclusion Adopting PDCA cycle management to strengthen the operation skill of venous indwelling, to strengthen the training of sealing tube and to optimize the health education for the family members of the child, can effectively reduce the incidence of venous indwelling and extravasation, and improve the satisfaction of the children s family.