PDCA模式结合临床路径护理在肝硬化腹水患者中的应用效果

Effect of PDCA mode combined with clinical pathway nursing on complications and leakage rate of intraperitoneal administration in patients with ascites due to cirrhosis

目的探究品质管理循环(PDCA)模式结合临床路径护理在肝硬化腹水患者中的应用效果。方法选取2019年3—9月郑州大学第一附属医院感染科肝硬化腹水患者418例为研究对象,按照随机数字表法分为对照组和研究组各209例,分别运用临床路径护理和PDCA模式结合临床路径护理进行干预,并比较2组患者腹腔置管局部漏液率、生命质量评分以及护理总满意度的情况。结果研究组在腹腔置管后0<时间≤24 h、24 h<时间≤48 h、48 h<时间≤72 h以及72 h<时间≤1周4个时间段,局部漏液率分别为17.22%(36/209)、14.83%(31/209)、12.92%(27/209)、8.61%(18/209),对照组分别为22.01%(46/209)、20.10%(42/209)、23.92%(50/209)、25.84%(54/209),其中48 h<时间≤72 h以及72 h<时间≤1周2个时间段差异有统计学意义(χ^2值为8.421、1.746,P<0.01)。研究组生命质量评分分别为(3.15±1.15)、(1.25±1.10)、(1.15±1.08)、(2.40±1.45)、(2.35±1.50)分,对照组分别为(3.75±1.05)、(3.25±1.05)、(3.60±1.25)、(4.35±1.25)、(3.15±1.25)分,差异均有统计学意义(t值为5.570~21.441,P<0.05)。研究组总满意度为96.65%(202/209),显著高于对照组总满意度85.65%(179/209),差异有统计学意义(χ2值为15.686,P<0.01)。结论PDCA模式结合临床路径护理能减少肝硬化腹水患者腹腔置管局部漏液率,提高患者生命质量评分及护理满意度,改进护理质量,是一种安全有效的护理模式。

Objective To explore the effect of quality management circulation(plan-do-check-act,PDCA)mode combined with clinical pathway nursing on leakage rate and nursing satisfaction in patients with ascites due to cirrhosis.Methods A total of 418 patients with cirrhotic ascites in hospital infectious department were selected and divided into control group and 209 patients in study group according to random digital table method.The leakage rate,quality of life score and total nursing satisfaction were compared between the two groups.Results The local leakage rates were 17.22%(36/209),14.83%(31/209),12.92%(27/209),8.61%(18/209),respectively,at 24 hours,48 hours,72 hours and 1 week after abdominal tube placement.The control group was 22.01%(46/209),20.10%(42/209),23.92%(50/209),25.84%(54/209).The difference between 72 hours and 1 week was statistically significant(χ^2 values were 8.421,1.746,P<0.01).Quality of life scores were(3.15±1.15),(1.25±1.10),(1.15±1.08),(2.40±1.45),(2.35±1.50)in the study group and(3.75±1.05),(3.25±1.05),(3.60±1.25),(4.35±1.25),(3.15±1.25)in the control group,and the difference was statistically significant(t values were 5.570-21.441,P<0.05).The total satisfaction of the study group was 96.65%(202/209),which was significantly higher than that of the control group 85.65%(179/209),and the difference was statistically significant(χ2 value was 15.686,P<0.01).Conclusion PDCA mode combined with clinical pathway nursing can reduce the leakage rate of abdominal administration,improve the quality of life score and nursing satisfaction,and improve the quality of nursing,which is a safe and effective nursing mode.