基于PDCA应用视频宣教提高患者咳痰标本合格率

Application of video education based on PDCA to improve the qualified rate of patients’ sputum specimens

目的探讨PDCA视频宣教在咳痰标本质量改进中的应用效果。方法对2017年3月13日-4月2日某院感染病科住院患者痰标本留取情况进行现状调查(作为改善前);实施PDCA对策(对策1:建立咳痰标本采集流程图;对策2:建立咳痰标本采集的考核标准;对策3:制作咳痰标本采集视频),以2017年5-7月作为改善中资料;2017年8-12月作为改善后资料,比较各阶段痰标本合格情况等。结果改善前,146例住院患者咳痰标本,其中45例合格,合格率为30.82%。“不能正确理解宣教内容”是痰标本不合格的首要原因,占79.21%(80/101)。通过PDCA循环,实施3个对策后,咳痰标本合格率均有提高,由改善前的31.51%(45/146)提高至67.33%(101/150),改善幅度达54.23%。其中采集视频播放后的咳痰标本,合格率从58.14%(25/43)提高至81.82%(54/66),升幅达23.68%,效果最明显。改善后连续5个月咳痰标本合格率波动在65%上下,较改善前明显提高,较改善中稍有回落,成效良好。结论应用视频宣教能有效改进住院患者咳痰标本留取质量,提高咳痰标本合格率,同时节省护理人员的时间和精力,优化工作流程,提高患者对护理服务的满意度。

Objective To explore the application effect of plan-do-check-act(PDCA)video education on quality improvement of sputum culture specimens.Methods Sputum specimens collected from hospitalized patients in the infectious diseases department of a hospital between March 13 and April 2,2017 were investigated(before improvement);PDCA countermeasures were implemented(countermeasure 1:establishing flow chart of sputum specimen collection;countermeasure 2:establishing examination standard of sputum specimen collection;countermeasure 3:making video of sputum specimen collection),May-July 2017 was as peri-improvement data,August-December 2017 was as post-improvement data,the qualified sputum specimens in different periods were compared.Results Before improvement,among 146 sputum specimens from hospitalized patients,45 of which were qualified,qualified rate was 30.82%.“Failure to correctly understand the content of education”was the primary cause for the unqualified sputum specimens,accounting for 79.21%(80/101).Through PDCA cycle,the qualified rate of sputum specimens increased from 31.51%(45/146)before improvement to 67.33%(101/150)after implementation of three countermeasures,and the improvement range was 54.23%.The qualified rate of sputum specimen collected after video broadcast increased from 58.14%(25/43)to 81.82%(54/66),increased by 23.68%,the effect was most obvious.After improvement,the qualified rate of sputum specimens fluctuated around 65%for consecutive 5 months,which was significantly higher than before improvement,slightly lower than peri-improvement,and achieved good results.Conclusion Video education can effectively improve the quality of sputum specimen collection and qualified rate of sputum specimens,at the same time,it can save time and energy of nurses,optimize the workflow and improve the satisfaction of patients for nursing services.