品管圈活动在提高血液透析患者动静脉内瘘绳梯穿刺落实率中的应用

Application of Quality Control Circle in Improving the Puncture Rate of Arteriovenous Fistula Ladder in Hemodialysis Patients

目的探讨品管圈活动在提高血液透析患者内瘘使用绳梯穿刺法落实率的应用效果。方法根据“护瘘”自愿原则,以提高护士对血液透析患者使用内瘘绳梯穿刺法落实率为主题,于2017年9月成立品质管理圈小组,由10名器官移植科血透室护士组成。采用“动静脉内瘘绳梯穿刺落实现况调查表”对血液透析患者动静脉内瘘绳梯穿刺进行调查,将结果汇总再设定目标值、原因分析、制定对策及实施,最后评估实施效果。结果品管圈活动开展后,内瘘绳梯穿刺法落实率由实施前的24.32%提高到40.32%,各位圈成员的责任心、自信心、积极性、品管手法、和谐度、解决问题能力等评分都有提高,团队凝聚力与沟通协调能力两方面提高最明显。结论品管圈活动能有效提高血液透析患者动静脉内瘘绳梯穿刺的落实率,减少动静脉内瘘并发症的发生、延长了动静脉内瘘的使用寿命,还提高了护士的团队合作意识和主动性。

Objective To explore the effect of quality control circle activities in improving the implementation rate of rope ladder puncture for internal fistula in hemodialysis patients.Methods According to the voluntary principle of"protecting the fistula",with the theme of improving the implementation rate of nurses using internal fistula ladders for hemodialysis patients,a quality management circle group was established in September 2017,composed of 10 hemodialysis nurses in the organ transplant department.The questionnaire on the implementation status of arteriovenous fistula ladder puncture and fall was used to investigate the puncture of arteriovenous fistula ladder in hemodialysis patients,and the results were summarized and then set to target values,cause analysis,countermeasures and implementation,and finally the implementation effect was evaluated.Results After the quality control circle activities were carried out,the implementation rate of the internal fistula rope ladder puncture method increased from 24.32%to 40.32%before implementation.Members of the circle have responsibility,self-confidence,enthusiasm,quality control methods,harmony,and problem solving capabilities The scores have improved,and team cohesion and communication and coordination skills have improved most significantly.Conclusion The quality control circle can effectively improve the implementation rate of arteriovenous fistula ladder puncture in hemodialysis patients,reduce the occurrence of arteriovenous fistula complications,prolong the service life of arteriovenous fistula,and improve the teamwork awareness of nurses and initiative.