分层量化考评管理在静脉治疗质量管理中的应用效果

Effects of hierarchical quantitative evaluation management in quality management of intravenous therapy

目的为了提高静脉治疗质量,保障患者安全,实施分层量化考评管理,并检验其在静脉治疗质量管理中的有效性。方法采用横断面调查的方法,选取2018年1—12月解放军总医院第八医学中心42个输液科室的在院输液患者3935例,制定分层量化考评管理办法,将其应用于静脉治疗质量管理过程中。在实施分层量化考评管理前(2018年1月初)依据观察指标对全院符合研究对象标准的输液患者进行横断面调查,实施后(2018年12月末)再次依据观察指标对全院符合研究对象标准的输液患者进行横断面调查,对比实施前后输液途径、穿刺部位、输液连接、应用药物、导管维护、敷贴固定、留置时间及输液并发症等8个维度的不同。结果实施分层量化考评后,钢针使用率、敷贴固定与维护问题、输液部位(下肢及关节)选择错误、穿刺点发红发生率均下降,留置针使用率升高,与实施前比较差异均有统计学意义(P<0.01)。结论分层量化考评在静脉治疗质量管理中的应用,充分发挥了静脉治疗专项小组的作用,有效调动了科室自我改进的积极性,可以提高静脉治疗质量,提升护士静脉治疗水平,保障患者安全。

Objective To implement hierarchical quantitative evaluation management and test its effectiveness in the quality management of intravenous therapy was in order to improve the quality of intravenous therapy and ensure the safety of patients.Methods In this cross-sectional study,totally 3935 patients receiving infusion in 42 infusion departments at the Eighth Medical Center of Chinese PLA General Hospital from January to December 2018 were selected.The hierarchical quantitative evaluation management method was developed and applied in the quality management of intravenous therapy.Before the introduction of the hierarchical quantitative evaluation management in early January 2018,a cross-sectional survey of the infusion patients in the hospital that met the inclusion criteria was conducted based on the observation indicators.After the implementation,at the end of December 2018,a cross-sectional survey was performed again on the infusion patients who met the inclusion criteria based on the observation indicators.The infusion route,puncture site,infusion connection,medication,catheter maintenance,application fixation,indwelling time,and infusion-relation complications were compared before and after the implementation.Results After the implementation of hierarchical quantitative evaluation,steel needle usage,application fixation and maintenance issues,wrong selection of infusion sites(lower limbs and joints),incidence of redness at puncture points decreased,and the use of indwelling needles increased,and there were statistically significant differences compared with those before the implementation(P<0.01).Conclusions The application of hierarchical quantitative evaluation in the quality management of intravenous therapy gives full play to the role of the intravenous therapy team,effectively mobilizes the enthusiasm for self-improvement of the department,which can improve the quality of intravenous therapy and the level of intravenous therapy for nurses,and ensure patients'safety.