品管圈在眼科住院患者眼药管理中的应用

Application of quality control circle in the management of eye drops for ophthalm-ological inpatients

目的利用品管圈(QCC)活动降低眼科住院患者的眼药漏滴率。方法成立QCC小组,确定圈名为“sunshine圈”,然后选定主题为“降低眼科住院患者眼药漏滴率”,通过现状调查确定活动前的漏滴率,按照80/20法则定位影响因素,最终确定主要原因,继而设定目标漏滴率。利用头脑风暴法,找出相应的解决策略,严格按照策略执行后,记录数据并行统计分析。结果(1)现状调查:活动前的漏滴率为15.00%,按照80/20法则定位影响因素,最终确定主要原因为“外出未归”和认识不足,继而设定目标漏滴率为降低至6.06%以下。(2)有形成果:活动后漏滴率为2.78%,低于设定的目标值;活动前后漏滴率比较,χ^(2)=4.293,P=0.038,差异有统计学意义。活动前后住院患者的满意度和住院天数比较,t_(满意度)=7.370,t_(住院天数)=9.502,均P=0.000,差异均有统计学意义。(3)无形成果:全体10名圈员在6项指标中均得到相应的提高,其中团队精神(t=6.187,P=0.000)、脑力开发(t=5.819,P=0.000)、QCC手法(t=4.791,P=0.000)、沟通协调(t=6.831,P=0.000)、活动信心(t=4.655,P=0.001)、责任荣誉(t=7.824,P=0.000),差异均有统计学意义。结论QCC活动在降低眼科住院患者眼药漏滴率中能发挥重要作用,可提高患者的满意度,有利于患者病情恢复,同时能锻炼QCC活动全体圈员的自我管理能力和科研能力,提高团队意识和合作精神,改善护理质量。

OBJECTIVE To reduce the rate of eye drops leakage in ophthalmic inpatients using of quality control circle(QCC)activities.METHODS We set up a QCC group which was called"sunshine",and then selected the theme of"decreasing the dropout rate of eye drops for hospitalized patients".Through the status quo survey,the group found the dropout rate of ophthalmic.According to the 80/20 rule to find the factors,the team finally identified the main reasons,and then set goals to cut the dropout rate.Brainstorm method was used to find out the corresponding solution strategy.After strictly following the implementation of the strategy,the data were recorded for statistical analysis.RESULTS(1)Status survey:The dropout rate of ophthalmic cases before the activity was 15.00%.According to the 80/20 rule,the team finally found out the main reasons were"out and not return"and"insufficient knowledge"and then set goals to cut the dropout rate to below 6.06%.(2)Achievements of the activity:the leakage rate after the activity was 2.78%,which was less than the goal,the difference was statistically significant(χ^(2)=4.293,P=0.038).For the comparison of degree of satisfaction(Ds)and Length of hospital stay(Lhs)before and after the activity,the differences were statistically significant(t_(Ds)=7.370,t_(Lhs)=9.502,both P=0.000).(3)Intangible achievements:After intervention,all circle members were improved in 6 indicators,including team spirit(t=6.187,P=0.000),mental development(t=5.819,P=0.000),QCC skills(t=4.791,P=0.000),communication and coordination(t=6.831,P=0.000),activity confidence(t=4.655,P=0.001)and responsibility honor(t=7.824,P=0.000).The differences were statistically significant.CONCLUSIONS QCC activitiy played an important role in decreasing the rate of eye drops leakage in ophthalmic inpatients,improving patient satisfaction,and facilitating the recovery of patients.At the same time,it exercised the self-management ability and scientific research ability of all members of the QCC,improved the awareness of team and cooperation,and the quality of nursing.