闭环管理模式在妇科护理安全质量持续改进管理中的应用

Application value of the closed-loop management model in safety and quality continuous improvement management of gynecological nursing

目的:探讨闭环管理模式在妇科护理质量持续改进中的应用。方法:自2020年3-8月将闭环管理模式应用于妇科护理质量持续改进管理中,通过护士自身、质控护士及护士长三级质控、住院病人满意度调查、电话回访等发现问题、讨论分析问题存在的根本原因、讨论整改措施、再进行整改措施的落实及措施效果评价、然后再巩固的步骤进行闭环管理,将管理运用前6个月2019年9月至2020年2月设为对照组,与管理运用后6个月2020年3月至2020年8月设为观察组,比较2组护理不良事件发生情况、病人对护理工作满意度、非计划性拔管率及妇科其他相关安全敏感指标情况。结果:通过闭环管理,观察组护理不良事件的发生率明显低于对照组(P<0.01),病人对护理工作的满意度明显优于对照组(P<0.01),病人身份识别准确率明显高于对照组(P<0.01);2组间非计划性拔管率、给药错误发生率和跌倒坠床发生率差异均无统计学意义(P>0.05)。结论:闭环管理模式运用于妇科护理质量持续改进管理中,能有效的提高病人对护理工作的满意度,降低护理不良事件的发生,改善妇科护理安全质量指标。

Objective:To explore the application value of closed-loop management model in safety and quality continuous improvement management of gynecological nursing.Methods:The closed-loop management model was applied in the continuous improvement management of gynecological nursing from March to August 2020,the problems were found through the nurses themselves,quality control nurses and head nurses three-level quality control,inpatient satisfaction survey and telephone return visit.The root cause of problems were discussed and analyzed,the rectification measures were formulated and implemented,the effects of the rectification measures were evaluated,and the modified measures were carried out.The six months before management application from September 2019 to February 2020 were set as the control group,and the six months after management application from March 2020 to August 2020 were set as the observation group.The incidence rate of nursing adverse events,patient satisfaction with nursing work,unplanned extubation rate and other safety sensitive indicators of gynecology were compared between two groups.Results:Through closed-loop management,the incidence rate of nursing adverse events in observation group was significantly lower than that in control group(P<0.01),the satisfaction of patients with nursing work in observation group was significantly better than that in control group(P<0.01),and the accuracy of patient identification in observation group was higher than that in control group(P<0.01).There was no statistical significance in the incidence rates of unplanned extubation and fall between two groups(P>0.05).Conclusions:The application of closed-loop management model in continuous improvement management of gynecological nursing quality can effectively improve the patients′satisfaction with nursing work,reduce the occurrence of nursing adverse events,and improve the safety and quality indicators of gynecological nursing.