重大传染病一级预检分诊持续质量控制

Continuous Quality Control of First-level Pre-Examination and Triage of Serious Infectious Diseases

目的对重大传染病一级预检分诊进行质量控制,并对影响分诊质量的主要因素进行分析、改进,提升一级预检分诊质量。方法选取2020年1月25日~2月10日我院就诊通过一级预检分诊的患者为研究对象,其中1月25日~1月30日就诊的患者设为首次质控组,2月4日~2月10日就诊的患者设为再次质控组,每组300例。首次质控时由质控团队对一级预检分诊进行现场督查,观察分诊人员是否将8个质控指标实施完善,评定每位患者预检分诊质量;再次质控组根据首次质控时分诊质量的主要因素进行持续改进后,再次由质控团队进行现场督查,患者分诊质量评定方法与首次质控时相同,比较两组分诊质量及8个质控指标实施情况。结果再次质控组分诊质量优良占比为90.33%,高于首次质控组的39.67%,差异有统计学意义(P<0.05)。两组暴露日期、暴露地点、有无咳嗽症状中完成占比比较,差异无统计学意义(P>0.05);而再次质控组暴露次数或总时间、暴露方式、体温异常是否复测、有无乏力症状、分诊登记是否清楚完成占比高于首次质控组,差异有统计学意义(P<0.05)。结论通过对一级预检分诊进行持续质量控制,可提高医院一级预检分诊的分诊质量,降低质控指标遗漏比例。

Objective Quality control of the first-level pre-examination and triage for serious infectious diseases is conducted,and the main factors affecting the quality of triage are analyzed and improved to upgrade the quality of the first-level pre-examination and triage.Methods From January 25 to February 10,2020,all patients who had passed the first-level pre-examination and triage were selected as the study objects.The patients who had visited the hospital from January 25 to January 30 were set as the first quality control group,and the patients who had visited the hospital from February 4 to February 10 were set as the second quality control group,with 300 cases in each group.During the first quality control,the quality control team conducted on-site supervision on the first-level of pre-examination and triage,observed whether the triage personnels had completed the 8 quality control indicators,and assessed the triage quality of each patient;After the quality control group made continuous improvement based on the main factors of triage quality during the first quality control,the quality control team again conducted on-site supervision.The evaluation method of patient triage quality was the same as that of the first quality control.Compare the quality of the two groups and 8 Implementation of each quality control index.Results The second quality control group accounted for 90.33%of the diagnosis quality,which was higher than 39.67%of the first quality control group,the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups of exposure date,exposure location,and the proportion of completion of cough symptoms(P>0.05);while the number of exposures or total time,exposure mode,and abnormal temperature of the second quality control group the proportion of no fatigue symptoms and whether the triage registration was clearly completed was higher than that of the first quality control group,the difference was statistically significant(P<0.05).Conclusion Through continuous quality control of the first-level pre-inspection and triage,the quality of the first-level pre-inspection and triage in the hospital can be improved and the percentage of missed quality control indicators can be reduced.