护理质量敏感指标在经桡动脉行冠状动脉介入术后肢体肿胀症状中的应用效果

Application effects of nursing quality sensitive indicator in the symptom of limb swelling after transradial coronary intervention

目的:探讨护理质量敏感指标在治疗经桡动脉行冠状动脉介入(transradial coronary intervention,TCI)术后肢体肿胀中的应用效果。方法:以病人发生肢体肿胀为结局指标,止血阀松解不规范、病人肢体摆放不正确、术后肢体锻炼指导不到位为3个过程指标,根据品管圈联合PDCA循环法,以2019年10-12月行TCI术病人84例为对照组,2020年1-3月行TCI术病人80例为观察组,比较2组病人肢体肿胀发生情况及疼痛评分的变化。结果:自2020年1月实施预防TCI术后肢体肿胀策略后,与对照组相比观察组病人肢体肿胀程度差异无统计学意义(P>0.05),但观察组无肿胀率(18.8%)高于对照组(3.6%),轻度肿胀发生率(40.0%)低于对照组(54.8%);术后2、4、8及24 h疼痛评分观察组均低于对照组,差异均有统计学意义(P<0.05~P<0.01)。结论:通过护理质量敏感指标找到TCI术后肢体肿胀质控存在的3个关键问题后进行针对性整改,能够进一步减轻疼痛,提高护理质量。

Objective:To explore the application effects of nursing quality sensitive indicator in the symptom of limb swelling after transradial coronary intervention(TCI).Methods:The patient′s limbs swelling was taken as the outcome index,and the irregular release of hemostatic valve,incorrect placement of patients′ limbs and inadequate guidance of postoperative limb exercise were taken as the process indexes.According to the quality control circle combined with PDCA cycle method,84 patients treated with TCI from October to December 2019 and 80 patients treated with TCI from January to March 2020 were divided into the control group and observation group,respectively.The occurrence of limb swelling and pain scores were compared between two groups.Results:After the implementation of the strategy to prevent limb swelling after TCI in January 2020,the differences of the degree of limb swelling between two groups were not statistically significant(P>0.05).The no limb swelling rate in observation group(18.8%) was higher than that in control group(3.6%),and the incidence rate of mild swelling in observation group(40.0%) was lower than that in control group(54.8%),and the differences of the pain scores in observation group after 2,4,8 and 24 h of operation were lower than those in control group(P<0.05 to P<0.01).Conclusions:Three key problems in the quality control of postoperative limb swelling after TCI can be found through the nursing quality sensitive indicator,and then targeted rectification,which can further reduce pain and improve the quality of nursing.