PDCA程序对危重症患者非计划拔管发生率的应用效果评价

An evaluation of the application effect of PDCA procedure on the incidence of unplanned extubation in critically ill patients

目的探讨PDCA程序对ICU危重症患者气管插管非计划拔管率的应用效果。方法运用PDCA(plan-do-check-act)持续质量改进模式为指导,回顾性分析2018年1~7月我院8个ICU病区气管插管非计划拔管(UEX)发生率高达4.38%的原因,并针对其原因于2019年1~12月实施改进措施。实施前后对随机调查200名护理人员的临床综合能力进行自身前后对比,评价应用PDCA前后的效果,实现质量持续改进。结果 8个ICU病区气管插管UEX发生率从4.38%下降至0.83%,ICU护理人员综合能力提高(P <0.05)。结论积极控制气管插管UEX是护理管理的重点,运用PDCA程序,可有效降低住院患者UEX发生率,同时能促进护理人员综合能力,有利于临床护理质量持续改进优化,提高医疗质量,保证患者安全。

Objective To explore the application effect of PDCA procedure on unplanned extubation(UEX)rate of tracheal intubation in ICU critically ill patients.Methods Under the guidance of PDCA(Plan-Do-Check-Act)continuous quality improvement model,the causes of the 4.38%high rate of UEX of tracheal intubation in 8 ICU wards of our hospital from January to July 2018 were analyzed retrospectively,and the targeted improvement measures were implemented from January to December 2019 in view of the causes.Before and after the implementation,the clinical comprehensive ability of 200 nurses randomly investigated was compared,and the effect before and after PDCA application was evaluated so as to realize continuous quality improvement.Results The UEX rate of tracheal intubation in the 8 ICU wards decreased from 4.38%to 0.83%,and the comprehensive ability of ICU nurses was improved(P<0.05).Conclusion Active control of UEX of tracheal intubation is the focus of nursing management.The application of PDCA procedure can effectively reduce the incidence of UEX in hospitalized patients,and it can meanwhile promote the comprehensive ability of nursing staff.It is conducive to continuous improvement and optimization of clinical nursing quality,amelioration of medical quality and guarantee ofthe safety of the patients.