提高护士对围手术期患者营养风险识别率中的品管圈实践

Using quality control circle to improve nurses’ recognition of nutritional risk in patients during the perioperative period

目的探讨品管圈活动在提高护士对围手术期患者营养风险的识别率中的应用效果。方法按品管圈活动步骤制定活动计划,调查护士对围手术期患者进行营养风险筛查的现状,设立活动目标,运用科学的方法分析要因,针对要因拟定对策并落实,同时进行持续的检讨与改进。选取2017年9月—12月(品管圈活动前)外科围手术期患者3302例和科室护士104名,以及2018年10月—2019年1月(品管圈活动后)选取围手术期患者3053例和科室护士110名为研究对象。结果护士对围手术期患者营养风险的识别率由0.97%(32/3302)提升至8.81%(269/3053)。品管圈活动后患者对围手术期营养宣教的满意度评分(9.10±1.30)分,高于活动前的(8.50±1.20)分,差异有统计学意义(P<0.05)。品管圈活动后护士对营养宣教满意度的自评得分(9.30±0.60)分,高于活动前的(7.20±1.10)分,差异有统计学意义(P<0.05)。结论品管圈有助于提高护士对围手术期患者营养风险的识别,促进营养护理工作质量的持续改善。

Objective To investigate the effect of quality control circle(QCC)activities on improving nurses'recognition of nutritional risk in patients during the perioperative period.Methods A QCC was established following steps of the plan-do-check-act(PDCA)model.The current status of nutrition risk screening for perioperative patients was investigated.Main factors influencing the nurses'recognition of nutritional risk were analyzed,and countermeasures were formulated and implemented continuously.Before implementation of QCC activities(September to December 2017),3302 patients undergoing surgical treatment and 104 surgical nurses participated in the survey.Totally 3053 surgical patients and 110 surgical nurses were included as research objects after the implementation of QCC activities(October 2018 to January 2019).Results The recognition rate of nutritional risk increased from 0.97%(32/3302)before the QCC activities to 8.81%(269/3053)after QCC activities.The score of patient satisfaction was(9.10±1.30)points after implementation of QCC activities,which was higher than(8.50±1.20)points before the implementation of QCC(P<0.05).The score of nurse satisfaction on health education increased form(7.20±1.10)points to(9.30±0.60)points,with a significant difference(P<0.05).Conclusion The QCC activity is potentially effective to enhance the nurses'recognition of nutritional risk in patients during the perioperative period,improve the quality of nutritional care.