质量控制图在护理不良事件管理中的应用研究

Application of quality control chart in management of nursing adverse events

目的探讨应用质量控制图对医院护理不良事件进行质量控制管理的可行性,实现护理安全管理持续质量改进的目标。方法对2015年1月至2017年12月医院护理系统上报的医院护理不良事件进行回顾性分析,判定是否符合正态分布,运用正态分布质量控制图计算院内护理不良事件上报率范围,设定护理不良事件上报警戒限与控制限。对2018年护理不良事件上报情况进行实时预警监测,对超出质量控制限范围并符合异常情况判断标准的月份提出警示,反馈指导临床护理不良事件管理。结果经过分析护理质量系统原因,重点通过降低护士离职率和事假人次进行针对性调控,完善质量控制流程,以获得的质量控制警戒限与控制限实时监测,2019年的护理不良事件住院床日发生率及平均住院日均较2018年降低。结论正态分布的护理不良事件数据可以运用质量控制图设定预警控制限,用于护理不良事件的实时监测,有利于护理安全质量管控及系统性问题判断。

Objective To explore the feasibility of applying quality control charts to quality control and management of hospital nursing adverse events,and to achieve the goal of continuous quality improvement in nursing safety management.Methods A retrospective analysis of the adverse events of hospital care reported by the hospital nursing system from January 2015 to December 2017 was conducted to determine whether they conform to the normal distribution.The normal distribution quality control chart was used to calculate the range of the reporting rate of adverse events of hospital care,and set alarm limits and control limits for adverse nursing events.Carried out real-time early warning and monitoring of the reporting of adverse nursing events in 2018,and provided warnings for months that exceeded the quality control limit and met the criteria for determining abnormal conditions,and provided feedback to guide the management of clinical nursing adverse events.Results After analyzing the causes of the nursing quality system,attention was focused on reducing the nurse turnover rate and the number of leave attendance for targeted regulation,and improving the quality control process to obtain real-time monitoring of the quality control warning limits and control limits.Both adverse nursing events occurring rate in terms of hospital bed days and average hospital stay in 2019 were lower than those in 2018.Conclusion The normal distribution of nursing adverse event data can be used to set the early warning control limit using the quality control chart,which is used for real-time monitoring of nursing adverse events,and is conducive to the control of nursing safety and quality and the judgment of systemic problems.