基于根因分析法在门诊静脉输液质量管理中的应用效果

Application of root cause analysis method in the management of care quality of intravenous infusion of outpatient

目的:探讨根因分析(RCA)法在门诊静脉输液质量管理中的应用效果。方法:采用RCA法进行门诊静脉输液护理管理,分析产生门诊静脉输液护理质量问题的原因,并制定相应对策。对比分析采用RCA法与常规护理管理法管理后护理质量问题发生情况、患者的护理满意度以及护理人员护理质量评分。结果:RCA法管理后反复穿刺、输液反应、服务态度不佳、挂号时间长、门诊噪音大、应答不及时、静脉炎、回血以及投诉纠纷护理质量问题发生率均低于常规护理管理法,其差异有统计学意义(x^2=21.689,x^2=9.360,x^2=16.037,x^2=10.304,x^2=11.774,x^2=11.346,x^2=13.029,x^2=13.457,x^2=4.988;P<0.05);实施RCA法管理后患者护理满意度为93.01%,高于常规护理管理法的73.02%,差异有统计学意义(x^2=370.478,P<0.05);管理后护理人员输液质量、岗位职责、业务技术、护士素质等护理质量各维度评分,RCA法均高于常规护理管理法,其差异有统计学意义(t=9.097,t=7.195,t=5.866,t=5.485;P<0.05)。结论:在门诊静脉输液护理质量管理中应用RCA法可显著减少护理质量问题发生情况,提高护理人员的护理质量,提升患者的护理满意度。

Objective:To explore the application effect of root cause analysis(RCA)method in the management of care quality of intravenous infusion of outpatient.Methods:The RCA method was adopted for managing the care of intravenous infusion in outpatient.Using root cause analysis method to analyze the reason of the problems about care quality of intravenous infusion,and then to formulate corresponding countermeasure.In addition,after the RCA method and routine care method were respectively applied,the occurrences of care quality problems,satisfaction of patients for care and care quality score of paramedic between the two methods were compared.Results:The incidences of repeated puncture,infusion reaction,poor service attitude,long registration time,large noise in outpatient,tardy response,phlebitis,backflow of blood and complaint about care quality of RCA method were significantly lower than that of routine care management method(x^2=21.689,x^2=9.360,x^2=16.037,x^2=10.304,x^2=11.774,x^2=11.346,x^2=13.029,x^2=13.457,x^2=4.988,P<0.05),respectively.And the satisfaction of patients after they received root cause analysis method(93.01%)was significantly higher than that after they received routine care method(73.02%)(x^2=370.478,P<0.05).Besides,the scores of infusion quality of paramedic,post obligation,operation skill,professional quality of nurse and other care quality after RCA method was implemented were significantly higher than that after routine care method was implemented(t=9.097,t=7.195,t=5.866,t=5.485,P<0.05).Conclusion:In the management of care quality of intravenous infusion of outpatient,the application of RCA method can significantly reduce the occurrences of care quality problems,and enhance care quality of paramedics and improve satisfaction of patients for care.