基于根因分析法的持续质量改进对神经外科重症患者非计划性拔管事件发生率的影响

The Effect of Continuous Quality Improvement Based on Root Cause Analysis on the Incidence of Unplanned Extubation in Severe Neurosurgical Patients

目的:探讨基于根因分析法的持续质量改进对神经外科重症患者非计划性拔管事件发生率的影响。方法:选取2014年1月-2016年12月笔者所在医院收治的50例神经外科重症患者作为对照组,给予常规护理;选取2017年1月-2018年6月收治的50例神经外科重症患者作为研究组,给予基于根因分析法的持续质量改进护理。比较两组非计划性拔管事件发生率、疼痛程度、护理舒适度及护理满意度。结果:研究组非计划性拔管事件发生率、轻度疼痛、重度疼痛均优于对照组(P<0.05);两组无痛及中度疼痛比较,差异均无统计学意义(P>0.05);两组干预前护理舒适度各维度评分比较,差异均无统计学意义(P>0.05);两组干预后护理舒适度各维度评分均高于干预前,且研究组均高于对照组,差异均有统计学意义(P<0.05)。研究组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论:基于根因分析法的持续质量改进在神经外科重症患者中应用可显著降低非计划性拔管事件发生率及患者疼痛程度,患者具有较高的护理舒适度及满意度。

Objective:To investigate the effect of continuous quality improvement based on root cause analysis on the incidence of unplanned extubation in severe neurosurgical patients.Method:Fifty severe neurosurgical patients admitted to our hospital from January 2014 to December 2016 were selected as the control group,who received routine nursing.Fifty severe neurosurgical patients admitted to our hospital from January 2017 to June 2018 were selected as the research group,who received continuous quality improvement based on root cause analysis.The incidence of unplanned extubation events,the degree of pain,nursing comfort and nursing satisfaction were compared between the two groups.Result:The incidence of unplanned extubation events,mild pain and severe pain in the research group were better than those of the control group(P<0.05).The painless and moderate pain were compared between the two groups,and the differences were not statistically significant(P>0.05).Before intervention,the scores of each dimension of nursing comfort were compared between the two groups,and the differences were not statistically significant(P>0.05).After intervention,the scores of each dimension of nursing comfort of the two groups were higher than those before intervention,and the research group were higher than those of the control group,and the differences were statistically significant(P<0.05).The nursing satisfaction of the research group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Continuous quality improvement based on root cause analysis can significantly reduce the incidence of unplanned extubation events and the degree of pain in patients with severe neurosurgery,and patients have higher nursing comfort and satisfaction.