基于品管圈出院计划管理对耳畸形再造术后康复的影响

Effects of a quality control circle-based discharge plan on rehabilitation after ear deformity reconstruction

目的 探讨基于品管圈出院计划管理对耳畸形再造术后患者康复的影响。方法 选择于哈尔滨医科大学附属第一医院行耳畸形再造术的先天性小耳畸形患者107例,根据护理方法的不同分为观察组57例与对照组50例,两组均于全麻下行耳畸形再造术,对照组术后给予常规出院计划管理,观察组给予基于品管圈的出院计划管理,记录两组术后康复情况。结果 术后3个月观察组与对照组再造耳郭优良率分别为100%(57/57)、88.0%(44/50),观察组再造耳郭优良率高于对照组(χ~2=7.246,P=0.007)。观察组与对照组并发症发生率分别为3.5%(2/57)、20.0%(10/50),观察组并发症发生率低于对照组(χ~2=7.275,P=0.007)。观察组与对照组术后3个月疼痛评分分别为(0.76±0.22)、(1.72±0.44)分,两组比较差异有统计学意义(t=9.133,P<0.001)。观察组与对照组术后3个月睡眠评分分别为(6.49±2.85)、(9.19±3.11)分,两组比较差异有统计学意义(t=5.922,P=0.014)。相较于对照组,观察组圈员解决问题能力、自信心、积极性、责任心等均明显提高,可运用品管圈活动解决工作中存在的问题。结论 基于品管圈的出院计划管理能促进耳畸形再造术后患者的康复,减少并发症的发生,改善患者的疼痛与睡眠障碍症状,提高护理质量。

Objective To explore the effects of a quality control circle-based discharge plan on the rehabilitation of patients after ear deformity reconstruction. Methods From February 2014 to January 2018, 107 patients with congenital microtia malformation who underwent ear deformity reconstruction in the First Affiliated Hospital of Harbin Medical University were enrolled in this study. Patients were divided into an observation group (n = 57) and a control group (n = 50), and received different nursing. All patients underwent general anesthesia during ear deformity reconstruction. The control group received routine discharge management after operation ,the observation group received discharge management based on a quality control circle, and the postoperative rehabilitation of the two groups was recorded. Results The excellent and good rates of reconstructed auricles were significantly higher in the observation group (100%, 57/57) than in the control group (88.0%, 44/50)(χ^2 = 7.246, P= 0.007). The incidence of complications was significantly lower in the observation group (3.5%, 2/57) than in the control group (20.0%, 10/50)(χ^2 = 7.275, P = 0.007). Additionally, pain scores of the observation group (0.76 ±0.22 points) were significantly lower than those of the control group (1.72±0.44 points)(t = 9.133, P = 0.000). The sleep scores of the observation group and the control group were 6.49±2.85 points and 9.19±3.11 points, respectively (t = 5.922, P = 0.014). Compared with the control group, the observation group's self-confidence ,enthusiasm, ability to solve daily and work problems, and sense of responsibility were significantly improved. Conclusion The discharge management plan based on a quality control circle can promote the recovery of patients after ear deformity reconstruction, reduce the occurrence of complications, improve the symptoms of pain and sleep disorders, and improve the quality of care.