医护患一体化联合PDCA管理模式在直肠癌预防性回肠造口患者护理中的应用

Study on the application effect of integrated medical and patient care combined with PDCA management model in the care of patients with prophylactic ileostomy for rectal cancer

目的 探讨医护患一体化联合“策划-实施-检查-措施(PDCA)”管理模式在直肠癌预防性回肠造口患者护理中的应用效果。方法 选取2019年1月~2022年12月于潍坊市人民医院结直肠肛门外科因直肠癌行腹腔镜下直肠癌根治术,并同时行预防性回肠造口的200例患者为研究对象。自2021年1月1日起,开始实施医护患一体化管理模式,并在管理过程中联合PDCA模式。将采用医护患一体化联合“PDCA”模式进行造口管理的患者作为试验组,将采用传统护理模式进行管理的患者作为对照组。比较两组患者造口并发症发生率、造口生活质量评分以及对医疗护理满意度。结果 试验组造口并发症发生率显著低于对照组(P<0.05);术后3个月,试验组患者在总评分、工作或社会功能维度、造口功能维度以及皮肤破损方面的生活质量均优于对照组(P<0.05);试验组患者对医护满意度高于对照组(P<0.05)。结论 医护患一体化联合PDCA管理模式可减少患者造口并发症发生率,改善肠造口患者生活质量,同时提高患者对医护工作的满意度,提高医疗护理质量。

Objective To explore the application effect of the integrated of medical care and patient care combined with the plan-do-check-act(PDCA) management model in the care of patients with prophylactic ileostomy for rectal cancer,and to explore its impact on the quality of medical care and patients' quality of life.Methods According to the inclusion and exclusion criteria,the clinical data and related follow-up information of 200 patients who underwent laparoscopic radical rectal cancer surgery with simultaneous prophylactic ileostomy for rectal cancer from January 2019 to December 2022 in the Department of Colorectal and Anal Surgery of the People's Hospital of Weifang were selected.Starting from January 1 2021,the integrated of medical care and patient management model will be implemented,and the PDCA management model will be added to the management process for continuous improvement.Patients with stoma management using the integrated of medical care and patient management model combined with the PDCA management model were taken as the experimental group,and patients with traditional nursing care model were taken as the control group.The two groups were evaluated in terms of stoma complication rate,stoma quality of life score and satisfaction with medical care.Results The incidence of stoma complications in the experimental group was significantly lower than that in the control group(P<0.05),and at 3 months postoperatively,the quality of life of patients in the experimental group was better than that in the control group in terms of total score,work or social function dimensions,stoma function dimensions,and skin irritation,with the difference being statistically significant(P<0.05).The patients' satisfaction with medical care in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The integrated of medical care and patient care combined PDCA management model can reduce the incidence of stoma complications,improve the quality of life of enterostomal patients,and at the same time,improve patient satisfaction with healthcare and improve the quality of medical care.