持续质量改进在降低下肢骨折患者骨牵引无效率中的应用

Application of continuous quality improvement in decreasing inefficiency ratio of skeletal traction in lower extremity fracture patients

目的下肢骨牵引是骨科常用的治疗手段，骨牵引治疗情况是骨科评价骨科专科护理质量指标之一。本研究通过对持续质量改进，为降低下肢骨折患者骨牵引无效率和提升专科护理品质提供依据。方法将下肢骨折骨牵引患者42例（304人次）按照入院时间分为：对照组［20例（146人次），2014年6~7月收治］和研究组［22例（158人次），2014年10~11月收治］。利用自制下肢骨牵引查检表对对照组患者下肢骨牵引情况进行调查，通过柏拉图分析法确定下肢骨牵引无效的主要类型，利用鱼骨图对其原因进行分析。针对分析结果进行持续护理质量改进并对实施持续质量改进的研究组患者进行效果评价。结果对照组的下肢骨牵引无效率为24.66%，研究组为8.86%，差异有统计学意义（P＜0.05）。结论对下肢骨折骨牵引患者进行持续质量改进，可有效地降低骨牵引无效率。

Objective Skeletal traction in lower limb is a common therapy and its outcome is one ofindicators evaluating nursing quality in orthopedics. The aim of this study was to evaluate the validity of con?tinuous quality improvement in decreasing the inefficiency ratio of skeletal traction in lower extremity fractureand increasing the nursing care quality. Methods The lower extremity fracture patients (n=42, 304 persons/times) who underwent skeletal traction from June to July in 2014 and from October to November in 2014 weredivided into 2 groups: the control group (n=20, 146 persons/times) and the research group (n=22, 158 persons/times). The self?checklist was used to investigate the conditions of skeletal traction patients in the control groupand analyze the type of invalid skeletal traction, and the plato was used to determine the principal types ofinvalid skeletal traction. As analyzed by fish bone, the root cause of invalid skeletal traction was the poor aware?ness of patients. Against the causes of invalid skeletal traction, the continuous nursing quality improvementgroup was established. PDCA circulation was used to improve nursing quality continuously and evaluate theeffectiveness of continuous quality improvement in patients of research group. Results There was significantdifference (χ2=13.779, P=0.000) in the inefficiency ratio of skeletal traction between the research group (8.86%)and control group (24.66%). Conclusion It can effectively decrease the inefficiency ratio of skeletal tractionin lower extremity fracture patients through continuous quality improvement.