PDCA循环管理对血液透析动静脉内瘘患者并发症、自护能力的影响

Effect of PDCA circulation management on complications and self-care ability of hemodialysis patients with arteriovenous internal fistula

目的 探讨在血液透析动静脉内瘘患者护理管理中应用PDCA循环管理对患者并发症及自我护理能力的影响效果。方法 随机抽取70例行动静脉内瘘穿刺治疗的血液透析患者作为研究对象,按照不同护理管理模式均分为2组,对照组实施常规护理,研究组实施PDCA循环管理,对比2组患者各项护理工作评分和护理管理后内瘘闭塞、瘘管感染、皮下血肿、高血钾的发生情况及自我护理管理评分情况。结果 研究组护理工作中基础护理、护理技术、护理责任心以及护理应急能力评分均高于对照组,护理管理后并发症(内瘘闭塞、瘘管感染、皮下血肿及高血钾)的总发生率低于对照组,患者护理管理后自我概念、自我责任感、自我护理技术、健康知识掌握评分及自我护理能力总评分均高于对照组,差异均有统计学意义(P<0.05)。结论 在血液透析动静脉内瘘患者的护理管理中应用PDCA循环管理,能有效完善各项护理工作,对于良好护患关系的建立也有非常重要的作用。

Objective To explore the effect of PDCA circulation management on complications and self-care ability of hemodialysis patients with arteriovenous internal fistula.Methods A total of 70 hemodialysis patients who were treated by arteriovenous fistula puncture were selected as the research objects.According to the nursing management mode,they were divided into two groups.Control group(n=35)was given routine nursing,and PDCA circulation management was given the research group(n=35).The scores of nursing work and occurrence of internal fistula occlusion,fistula infection,subcutaneous hematoma,hyperkalemia and self-care management scores after management were compared between the two groups.Results The scores of basic nursing,nursing technology,nursing responsibility and nursing emergency ability in the study group were higher than those in the control group(P<0.05),the incidence of complications,including internal fistula occlusion,fistula infection,subcutaneous hematoma and hyperkalemia after nursing management was lower than that in the control group(P<0.05).The patients'scores of self-concept,self-responsibility,self-nursing technology,mastery of health knowledge and total scores of self-nursing ability after nursing management were lower than those in the control group(P<0.05).Conclusion PDCA circulation management in patients with arteriovenous fistula can effectively improve nursing work and play an important role in the establishment of good nurse-patient relationship.