基于QCC的链式质控护理管理措施在急诊PCI患者中的应用

Application of chain quality control nursing management measures based on QCC in patients undergoing emergency PCI

目的 观察基于品管圈(QCC)的链式质控护理管理措施在急诊经皮冠状动脉介入术(PCI)患者中的应用效果。方法 选取2020年7月至2021年6月于空军军医大学第二附属医院行急诊PCI的128例患者为研究对象。按照随机数表法分研究组和对照组各64例。对照组患者行常规护理,研究组患者在对照组的基础上行基于QCC的链式质控护理。比较两组患者急诊室进出时间、住院时间、急诊到球囊扩张时间与随访6个月生活质量健康调查简表(SF-36)评分、心功能指标[包括N末端B型利钠肽原(NT-proBNP)、6min步行距离、左心射血分数]、不良事件发生情况。结果 研究组患者的急诊室进出时间、住院时间、急诊到球囊扩张时间分别为(48.65±9.87) min、(8.85±1.93) d、(47.50±10.32) min,明显短于对照组的(60.36±11.24) min、(13.10±3.52) d、(66.09±11.21) min,差异均有统计学意义(P<0.05);随访6个月,研究组患者的总体健康、躯体健康、躯体疼痛、情绪角色、躯体角色、社会功能、精力、精神健康评分分别为(51.04±8.26)分、(76.92±18.37)分、(77.26±13.29)分、(75.15±18.24)分、(61.33±16.31)分、(72.26±8.42)分、(77.15±8.93)分、(70.35±6.74)分,明显高于对照组的(43.28±7.31)分、(55.83±16.14)分、(67.91±10.37)分、(64.25±17.49)分、(50.02±15.09)分、(60.56±7.25)分、(65.81±9.46)分、(60.77±5.01)分,差异均有统计学意义(P<0.05);研究组患者的NT-proBNP为(357.14±28.54) ng/mL,明显低于对照组的(392.71±30.26) ng/mL,左心射血分数、6 min步行距离为(59.26±6.37)%、(420.73±58.41) m,明显高于对照组的(53.08±5.96)%、(363.96±51.85) m,差异均具有统计学意义(P<0.05);研究组患者的不良事件发生率为25.00%,明显低于对照组的48.44%,差异有统计学意义(P<0.05)。结论 基于QCC的链式质控护理管理措施应用于急诊PCI中可缩短患者的住院时间,有效改善心功能及生存质量,同时还能降低不良事件发生率,值得推广应用。

Objective To observe the application effect of quality control circle(QCC)-based chain quality control nursing management measures in patients undergoing emergency percutaneous coronary intervention(PCI).Methods A total of 128 patients who underwent emergency PCI in Second Affiliated Hospital of Air Force Military Medical University from July 2020 to June 2021 were selected as the research subjects. According to the random number table method, they were divided into the study group and the control group, with 64 cases in each group. The control group received routine nursing care, and the study group received chain quality control nursing based on QCC on the basis of the control group. After 6 months of follow-up, the time of entering and leaving the emergency room, length of hospital stay,time from emergency to balloon dilation, and 36-item Short-Form(SF-36) Health Survey score at follow-up of 6 months,cardiac function indicators [including N-terminal pro-B-type natriuretic peptide(NT-proBNP), 6-min walking distance,left ventricular ejection fraction], and incidence of adverse events were compared between the two groups. Results The time of entering and leaving the emergency room, length of hospital stay, and time from emergency to balloon dilation were(48.65±9.87) min,(8.85±1.93) d, and(47.50±10.32) min in the study group, which were significantly shorter than(60.36±10.32) min,(13.10±3.52) d,(66.09±11.21) min in the control group(P<0.05). At follow-up of 6 months, the general health, physical health, physical pain, emotional role, physical role, social function, energy, and mental health scores of the patients in the study group were(51.04±8.26) points,(76.92±18.37) points,(77.26±13.29) points,(75.15±18.24) points,(61.33±16.31) points,(72.26±8.42) points,(77.15±8.93) points,(70.35±6.74) points, significantly higher than(43.28±7.31) points,(55.83±16.14) points,(67.91±10.37) points,(64.25±17.49) points,(50.02±15.09) points,(60.56±7.25) points,(65.81±9.46) points,(60.77±5.01) points in the control group(P<0.05). The NT-proBNP of the study group was(357.14±28.54) ng/mL, which was significantly lower than(392.71±30.26) ng/mL of the control group, and left cardiac ejection fraction and 6-min walking distance were(59.26±6.37)% and(420.73±58.41) m, which were significantly higher than(53.08±5.96)% and(363.96±51.85) m in the control group, with statistically significant differences(P<0.05). The incidence of adverse events in the study group was 25.00%, which was significantly lower than 48.44% in the control group(P<0.05). Conclusion The application of QCC-based chain quality control nursing management measures in patients undergoing emergency PCI can shorten the length of hospital stay, effectively improve the cardiac function and quality of life of patients, and reduce the incidence of adverse events, which is worthy of popularization and applicatio.