品管圈在降低神经内科鼻胃管非计划拔管中的应用

Application of QCC in Reducing the Rate of Unplanned Extubation in the Department of Neurology with Indwelling Gastric Tube

目的探讨品管圈模式管理在降低神经内科鼻胃管非计划拔管率的同时,能否降低护理成本,提高神经内科患者的护理质量.方法随机抽取昆明医科大学第四附属医院神经内科病区实施品管圈模式管理前(2015年7月至8月)留置鼻胃管患者50例为对照组,神经内科病区实施品管圈模式管理后(2015年12月至2016年2月)留置鼻胃管患者51例为实验组.实验组在对策拟定阶段,加入循证护理方法,拟定对策为系带鼻胃管固定方法.调查的内容包括:品管圈模式管理前后神经内科病区鼻胃管非计划拔管率、留置鼻胃管的工作时数、留置鼻胃管的护理成本.使用SPSS17.0统计软件对数据进行统计分析.结果 2组在年龄、性别、疾病种类上无统计学差异(P>0.05).2组患者的留置鼻胃管非计划拔管率比较,非计划拔管率由62.00%下降到17.65%;留置鼻胃管耗材费用比较,每位留置鼻胃管患者耗材费用由(11.81±9.08)元/人下降至(7.30±2.53)元/人;留置鼻胃管护理用时比较,每位留置鼻胃管患者护理用时由(13.22±10.77)min/人下降到(7.48±2.56)min/人.差异均具有统计学意义(P<0.05)结论应用品管圈管理降低了神经内科鼻胃管非计划拔管率,降低了护理成本,减轻了护士工作量,提高了护理质量.

Objective To discuss the effect QCC in reducing the unplanned extubation rate of nasogastric tube,nursing cost in Department of Neurology and improve the quality of nursing at the same time.Methods We randomly selected the Department of Neurology in the fourth affiliated hospital of Kunming Medical University.Before QCC management,there are indwelling nasogastric tube50cases as control group on July to August,2015.After QCC management,there are indwelling nasogastric tube51cases as experimental group on December2015to February2016.In the strategy step,We add evidence based nursing method,making the literature search strategy closely,chose nasal bridles.The contents of the survey include:The rate of unplanned extubation of nasogastric tube,working hours in indwelling nasogastric tube,nursing cost before and after the QCC management mode in Department of Neurology.Statistical analysis of data using SPSS17.0statistical software.Result The two groups had no significant difference in age,gender,disease(P>0.05).Compared with the two groups,the unplanned extubation rate decreased from62%to17.65%,the cost of materials decreased from(11.81±9.08)yuan/person to7.30±2.53yuan/person(P<0.05),the working hours of nasogastric tube placement decreased from(13.22±10.77)minutes/person to(7.48±2.56)minutes/person(P<0.05).The differences were statistically significant(P<0.05).Conclusions The QCC mode can reduce unplanned extubation rate of neurological nasogastric tube,reduce the cost of care and improve the quality of patient care in the Department of Neurology.