以“根因分析法”指导质量管理在发热门诊中的应用价值分析

Analysis of the value of applying “Root cause analysis” guided quality management in fever clinic

目的 探讨基于根本原因分析法(RCA)的质量管理在发热门诊中的应用价值。方法 回顾性分析2019年1—12月及2020年2月—2021年2月本院发热门诊收治的患者临床资料,各选择1000例分别纳入对照组和观察组。对照组采用常规护理质量管理,观察组则在质量管理中应用RCA法,对近2年发热门诊风险事件、患者投诉进行深入细致调查,采用流程图还原事件过程,组织对案例进行讨论分析,分析原因并制定改进措施。比较两组护理风险管理质量、护理管理质量,记录风险事件发生及投诉情况,评价患者满意度。结果 观察组护理风险管理态度、技能、知识评分均显著高于对照组(P<0.05)。观察组护士查对制度、护理文书、病房管理、护理过程、手卫生、自我防护评分均显著高于对照组(P<0.05)。观察组风险事件发生率及患者投诉率显著低于对照组(P<0.05)。观察组患者满意度评分显著高于对照组(P<0.05)。结论 通过开展基于RCA分析的质量管理,有利于提升发热门诊护理人员专业素养,减少风险事件及患者投诉,提高护理满意度。

Objective To explore the application value of quality management based on root cause analysis(RCA) in fever clinic.Methods The clinical data of patients those were admitted to the fever outpatient department of Zhengzhou seventh people’s hospital from January 2019 to December 2019 and from February 2020 to February 2021 were retrospectively analyzed, and 1000 cases were selected into the control group and 1000 cases were selected into observation group.The control group adopted routine nursing quality management, while the observation group received RCA method in quality management to conduct in-depth and detailed investigation of fever outpatient risk events and patient complaints in the past two years, restored the event process with flow chart, organized discussion and analysis of cases, analyzed the reasons and formulated improvement measures.The quality of nursing risk management and nursing management were compared between the two groups, recorded the occurrence of risk events and complaints, and evaluated patient satisfaction.Results The scores of nursing risk management attitude, skills and knowledge in the observation group were significantly higher than those in the control group(P<0.05).The scores of nurses in the observation group on the check system, nursing documents, ward management, nursing process, hand hygiene and self-protection were significantly higher than those in the control group(P<0.05).The incidence of risk events and the complaint rate of patients in the observation group were significantly lower than those in the control group(P<0.05).The satisfaction score of patients in the observation group was significantly higher than that in the control group(P<0.05).Conclusions The carrying out of quality management based on RCA analysis, is beneficial to improve the professional quality of nursing staff in fever outpatient department, reduce risk events and patient complaints, and improve nursing satisfaction.