根本原因分析法在妇科术后留置针管理中的应用

Application of Root Cause Analysis in the Management of Indwelling Needles after Gynecological Surgery

目的探讨根本原因分析法在妇科术后留置针管理中的应用及效果。方法 2018年1—6月实施根本原因分析法改进妇科留置针护理管理质量,选择实施前120例患者作为对照组,实施后120例患者作为研究组,比较两组患者留置针护理管理质量。结果一次穿刺成功率研究组为94.2%,对照组为74.2%,研究组一次穿刺成功率高于对照组(χ^2=4.142,P<0.001),非计划拔针率、留置针相关并发症发生率研究组为9.2%,2.5%,对照组为26.7%,15.8%,研究组非计划拔针率、留置针相关并发症发生率均低于对照组(χ^2=5.384,P<0.001;χ^2=6.195,P<0.001),留置针使用时间对照组为(3.9±0.4)d,研究组为(4.8±0.2)d,研究组留置针使用时间长于对照组(t=3.476,P=0.009)。结论根本原因分析法能够改进留妇科置针护理流程,提高留置针的使用质量。

Objective To explore the application and effect of root cause analysis in the management of indwelling needles after gynecological surgery. Methods From January to June 2018, the root cause analysis method was implemented to improve the quality of gynecological indwelling needle care management. 120 patients before the implementation were selected as the control group, and 120 patients after the implementation were selected as the research group, and the quality of care management of the indwelling needles was compared between the two groups.Results The one-time puncture success rate was 94.2% in the study group and 74.2% in the control group. The onetime puncture success rate in the study group was higher than that in the control group(χ^2=4.142, P<0.001). The rate of unplanned needle removal and indwelling needle related complications of the study group was 9.2%, 2.5%, the control group was 26.7%, 15.8%. The unplanned needle removal rate and the incidence of indwelling needle-related complications in the study group were lower than those in the control group(χ^2=5.384, P<0.001;χ^2=6.195, P<0.001),the indwelling needle use time was(3.9±0.4)d in the control group and(4.8±0.2)d in the study group. The indwelling needle used time in the study group was longer than that of the control group(t=3.476, P=0.009). Conclusion The root cause analysis method can improve the nursing process of gynecological needle placement and improve the quality of indwelling needle use.