PDCA循环联合鱼骨图分析提升护士压力性损伤预防能力的效果观察

Effect of fishbone diagram analysis combined with PDCA in improving the nurses'ability to prevent the pressure injury

目的探讨PDCA循环法联合鱼骨图分析提升护士压力性损伤风险预防能力的效果。方法本研究为类试验性研究。2021年12月选取广东省人民医院河源医院31名护士作为研究对象,工作年限4~30年,年龄(31.32±7.27)岁。于2022年1月起通过绘制鱼骨图分析影响护士压力性损伤风险评估能力的因素,并开展PDCA活动:明确专科小组成员的工作职责、考核制度,完善工作流程及压力性损伤风险管理制度,制定压力性损伤预防健康宣教图文手册以及宣教视频。采取自身前后对照,比较2021年12月(实施前)与2022年6月(实施后)护士压力性损伤相关知识考核得分、压力性损伤高风险预防措施落实率。统计学方法采用配对t检验、χ^(2)检验。结果实施PDCA活动后,护士压力性损伤相关知识考核得分高于实施前[(87.27±15.53)分比(60.45±8.18)分],压力性损伤预防措施落实率高于实施前[88.83%(152/172)比77.69%(101/130)],差异均有统计学意义(t=-8.74,P=0.02;χ^(2)=6.21,P=0.01)。结论PDCA循环联合鱼骨图分析能有效提升护士压力性损伤风险预防能力。

Objective To explore the effect of fishbone diagram analysis combined with PDCA in improving the nurses'ability to prevent the pressure injury.Methods This study was a quasi-experimental study.A total of 31 nurses were selected as the research subjects from Heyuan Hospital of Guangdong Provincial People's Hospital in December 2021,with working life of 4-30 years,aged(31.32±7.27)years.Since January 2022,we analyzed the factors that affected nurses'pressure injury risk assessment ability by drawing a fishbone diagram.Then we carried out the PDCA activities:(1)defining the work responsibilities and assessment system of the members of the specialist team;(2)refining the workflow to enhance the high-risk assessment of pressure injury;(3)developing pictorial health education manual and video for pressure injury prevention.The scores of nurses'pressure injury related knowledge and the implementation rate of pressure injury prevention measures for high-risk patients were compared before the implementation(December 2021)and after the implementation(June 2022).Paired t test andχ^(2) test were used for statistical analysis.Results After the implementation of PDCA activities,the score of nurses'stress injury related knowledge examination was higher than that before the implementation[(87.27±15.53)points vs.(60.45±8.18)points],and the implementation rate of pressure injury prevention measures for high-risk patients was higher than that before the implementation[88.83%(152/172)vs.77.69%(101/130)],with statistically significant differences(t=-8.74,P=0.02;χ^(2)=6.21,P=0.01).Conclusion Fishbone diagram analysis and PDCA can improve the nurses'ability to prevent the pressure injury.