六西格玛管理降低老年心血管病患者鼻胃管非计划性拔管率的应用实践

Application and practice of the Six Sigma management in reducing unplanned extubation rate of nasogastric tube in elderly patients with cardiovascular disease

目的 探讨六西格玛管理降低老年心血管疾病患者鼻胃管非计划性拔管发生率的效果.方法 采用六西格玛管理法定义、测量、分析、改进和控制5个步骤,优化鼻胃管固定和维护流程,对关键点进行细节改进,保证鼻胃管留置期间安全和有效.实施六西格玛管理前收集老年心血管科2016年1月-8月留置胃管患者198例次资料,改进措施落实后,收集2016年11月-2017年6月鼻胃管留置患者185例次资料.结果 老年心血管疾病患者鼻胃管非计划性拔管发生率由实施前的6.06%降低到实施后的1.08%(P<0.05).结论 应用六西格玛管理法对病区原先制定的鼻胃管固定和维护流程进行优化和细节管理,有效降低了鼻胃管非计划性拔管发生率,提高了专科护理内涵,保证了患者管道安全.

Objective To investigate the Six Sigma management in reducing unplanned extubation rate of nasogastric tube in elderly patients with cardiovascular disease. Methods A Six Sigma approach was adopted to optimize the fixation and maintenance of nasogastric tube among elderly patients with cardiovascular disease. The Six Sigma approach consisted of definition, measurement, analysis, improvement and control. The clinical data of 198 elderly patients receiving the placement of nasogastric tube between January 2016 and August 2016 were collected. After two months of intervention, the clinical data of 185 elderly patients receiving the placement of nasogastric tube between November 2016 and June 2017. Results After implementation of Six Sigma management, the unplanned extubation rate of nasogastric tube was decreased from 6.06% to 1.08%(P<0.01). Conclusion The application of Six Sigma management is potentially effective to reduce the unplanned extubation rate of nasogastric tube in elderly patients with cardiovascular disease. It is an effective approach to improve the quality of nursing and ensure the safety of patients during catheter placement.