持续改进在提高缩宫素使用规范中的应用

Application of Continuous Improvement in Improving Oxytocin Usage Norms

目的针对缩宫素在妇产科的应用问题,采取持续质量改进措施提升缩宫素的使用规范性。方法选取2019年1—7月该院收治的使用了缩宫素治疗的210名产妇作为研究对象,其中按常规方法使用缩宫素的105名产妇视为对照组,规范性使用缩宫素的105名产妇视为观察组。比较两组助产护士对缩宫素规范使用认知评分,并发症发生率、缩宫素使用规范率、医患纠纷发生率以及产妇满意度。结果对照组助产护士对缩宫素使用认知总评分为(169.35±10.91)分,观察组助产护士对缩宫素使用认知总评分为(186.39±11.99)分,观察组均高于对照组,差异有统计学意义(t=3.641,P<0.05)。对照组9名发生并发症,并发症发生率为8.57%(9/105);观察组2名发生并发症,并发症发生率为1.90%(2/105),观察组低于对照组,差异有统计学意义(χ2=4.701,P<0.05)。对照组缩宫素使用规范率为62.86%(66/105),医患纠纷发生率为11.43%(12/105),产妇满意度为85.71%(90/105);观察组缩宫素使用规范率为86.67%(91/105),医患纠纷发生率为3.81%(4/105),产妇满意度为94.29%(99/105),观察组缩宫素使用规范率和产妇满意度均高于对照组,医患纠纷发生率低于对照组,差异有统计学意义(χ2=15.773、4.330、4.286,P<0.05)。结论缩宫素使用过程中存在一定的不规范性问题,加强对缩宫素使用的质量改进,提升缩宫素使用的规范性,有利于增强助产护士对缩宫素使用的认知,提升缩宫素使用规范率,降低并发症和医患纠纷的发生率,容易获得产妇的认可。

Objective In view of the application of oxytocin in obstetrics and gynecology,to adopt continuous quality improvement measures to improve the use of oxytocin standard.Methods 210 partarient treated with oxytocin in the hospital from January to July 2019 were selected as research objects.Among them,105 partarient treated with oxytocin by conventional methods were considered as control group and 105 partarient treated with oxytocin by normative methods were considered as observation group.The cognitive scores,incidence of complications,standard use of oxytocin,incidence of doctor-patient disputes and partarient satisfaction of midwives in the two groups were compared.Results The total cognition score of midwife nurses in the control group for oxytocin use was(169.35±10.91)points,and the total score of oxytocin use cognition by midwife nurses in the observation group was(186.39±11.99)points,and the observation group was higher than the control Group,the difference was statistically significant(t=3.641,P<0.05).There were 9 complications in the control group,with a complication rate of 8.57%(9/105);2 complications in the observation group,with a complication rate of 1.90%(2/105),the observation group was lower than the control group,the difference was There is statistical significance(χ2=4.701,P<0.05).The standard rate of oxytocin use in the control group was 62.86%(66/105),the incidence of medical disputes was 11.43%(12/105),and the partarient satisfaction rate was 85.71%(90/105);the observation group was standard oxytocin use The rate was 86.67%(91/105),the incidence of doctor-patient disputes was 3.81%(4/105),and the partarient satisfaction rate was 94.29%(99/105).The standard rate of oxytocin use and partarient satisfaction in the observation group were both high In the control group,the incidence of doctor-patient disputes was lower than that in the control group,and the difference was statistically significant(χ2=15.773,4.330,4.286,P<0.05).Conclusion Oxytocin in use process there is no normative problems,to strengthen the quality improvement of oxytocin use,promote the use of oxytocin normative,is conducive to enhance nurse midwife cognitive over the use of oxytocin,increase the standard rate of oxytocin norms,reduce the complications and the incidence of medical disputes,easy access to the partarient's approval.