品管圈在降低新生儿桡动脉穿刺皮下血肿淤青率中的应用

Application of Quality Control Circle in Reducing the Bruising Rate of Subcutaneous Hematoma in Neonatal Radial Artery Puncture

目的探讨品管圈(quality control circle,QCC)活动在降低新生儿桡动脉穿刺皮下血肿淤青率中的应用效果。方法南京医科大学附属江宁医院新生儿科于2023年5—10月开展以“降低新生儿桡动脉穿刺皮下血肿淤青率”为主题的QCC活动。选取QCC活动前,即2023年5月5—23日新生儿科住院患儿(n=41)进行桡动脉穿刺52次作为对照组,分析桡动脉穿刺皮下血肿淤青发生率现状,进行原因分析并制定对策。选取QCC活动后即2023年9月9—27日新生儿科住院患儿(n=42)进行桡动脉穿刺52次作为试验组,进行效果确认,计算目标达成率和进步率,标准化持续实施。结果试验组桡动脉穿刺患儿皮下血肿淤青率为21.15%,低于对照组的50.00%,差异有统计学意义(P<0.001)。目标达成率为101.94%,进步率为57.70%。QCC实施后,圈员QCC手法的运用、团队精神、沟通协调能力、活动信心、责任荣誉、积极性均有一定程度提升。结论QCC活动可降低新生儿桡动脉穿刺皮下血肿淤青发生率,提高圈员综合能力。

Objective To explore the application effect of quality control circle(QCC)activity in reducing the bruising rate of subcutaneous hematoma in neonatal radial artery puncture.Methods The department of neonatology,the Affiliated Jiangning Hospital of Nanjing Medical University will carry out QCC activities with the theme of"reducing the bruising rate of subcutaneous hematoma in neonatal radial artery puncture"from May to October 2023.Before QCC activity,52 radial artery punctures were performed on 41 hospitalized children in the neonatal department from May 5 to 23,2023 as the control group.The incidence of subcutaneous hematoma bruising in radial artery puncture was analyzed,the causes were analyzed and countermeasures were formulated.After QCC activity,52 radial artery punctures were performed on 42 hospitalized children in the neonatal department from September 9 to 27,2023 as the experimental group.The effect was confirmed,the goal achievement rate and progress rate were calculated,and the standardization was continuously implemented.Results The subcutaneous hematoma bruising rate in the experimental group was 21.15%,which was lower than 50.00%in the control group,and the difference was statistically significant(P<0.001).The target achievement rate was 101.94%,and the progress rate was 57.70%.After the implementation of the QCC,the application of QCC methods,team spirit,communication and coordination ability,activity confidence,responsibility and honor,and enthusiasm of the circle members have been improved to a certain extent.Conclusion QCC can reduce the incidence of subcutaneous hematoma bruising in neonatal radial artery puncture and the comprehensive ability of circle members.