医护联合专项质控小组质控护理在维持性血液透析患者质量管理中的应用

Application of quality control nursing by the joint special quality control team of medical staff and nurses in the quality management of patients undergoing maintenance hemodialysis

目的研究医护联合专项质控小组质控护理在维持性血液透析患者质量管理中的应用效果。方法回顾性分析2022年2月至2024年2月中山市人民医院收治的86例维持性血液透析住院患者的临床资料,按照不同护理干预方法将患者分为观察组(n=40)和对照组(n=46)。对照组患者实施常规护理,观察组患者在常规护理基础上实施医护联合专项质控小组质控护理。两组患者均护理至出院。比较两组患者透析治疗完成后的透析充分性[尿素清除率(URR)、尿素清除指数(Kt/V)]、入院时及出院时心理状况[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、入院时及出院时生活质量[健康调查简表(SF-36)],同时比较两组患者出院时的治疗依从性。结果出院时,观察组患者的URR为(58.21±6.22)%,明显低于对照组的(63.49±7.31)%,Kt/V为1.56±0.33,明显高于对照组的0.94±0.19,差异均有统计学意义(P<0.05);观察组患者的HAMD、HAMA评分分别为(8.28±0.40)分、(9.13±0.32)分,明显低于对照组的(19.15±0.82)分、(18.70±0.82)分,差异均有统计学意义(P<0.05);观察组患者的躯体疼痛、生理机能、精力、生理职能、社会功能、精神健康、情感职能、一般健康状况评分分别为(66.13±7.08)分、(80.77±7.93)分、(66.70±8.35)分、(50.35±7.76)分、(65.36±7.28)分、(80.03±8.13)分、(68.48±6.90)分、(62.31±9.14)分,明显高于对照组的(55.63±7.46)分、(69.76±8.38)分、(59.32±8.49)分、(42.47±8.03)分、(59.48±7.55)分、(70.53±8.75)分、(56.21±7.23)分、(54.26±9.47)分,差异均有统计学意义(P<0.05);观察组患者的治疗依从性为95.00%,明显高于对照组的76.09%,差异有统计学意义(P<0.05)。结论医护联合专项质控小组质控护理在维持性血液透析患者护理中的应用效果显著,能有效提高透析充分性,改善透析质量指标,缓解抑郁、焦虑等负性情绪,提高生活质量和依从性,值得临床推广应用。

Objective To investigate the application effect of quality control nursing by the joint special quality control team of medical staff and nurses in the quality management of patients undergoing maintenance hemodialysis.Methods The clinical data of 86 hospitalized patients undergoing maintenance hemodialysis admitted to Zhongshan tervention methods,the patients were divided into an observation group(n=40)and a control group(n=46).Patients in the control group received routine nursing,while those in the observation group received quality control nursing by the joint special quality control team of medical staff and nurses on the basis of routine nursing.Both groups of patients were cared for until discharge.The changes in dialysis adequacy[urea clearance rate,URR;urea kinetic index,Kt/V]af-ter dialysis treatment,psychological status(Hamilton Anxiety Scale,HAMA;Hamilton Depression Scale,HAMD)at ad-mission and discharge,quality of life(36-Item Short Form Health Survey,SF-36)at admission and discharge,and treat-ment compliance at discharge were observed and compared between the two groups.Results At discharge,the URR of the observation group was(58.21±6.22)%,which was significantly lower than(63.49±7.31)%of the control group;the Kt/V was 1.56±0.33,which was significantly higher than 0.94±0.19 of the control group;the differences were statistical-ly significant(P<0.05).The HAMD and HAMA scores of the observation group were(8.28±0.40)points and(9.13±0.32)points,which were significantly lower than(19.15±0.82)points and(18.70±0.82)points of the control group(P<0.05).The bodily pain,physical functioning,vitality,role physical,social functioning,mental health,role emotional,and general health scores of the observation group were(66.13±7.08)points,(80.77±7.93)points,(66.70±8.35)points,(50.35±7.76)points,(65.36±7.28)points,(80.03±8.13)points,(68.48±6.90)points,and(62.31±9.14)points,which were significantly higher than(55.63±7.46)points,(69.76±8.38)points,(59.32±8.49)points,(42.47±8.03)points,(59.48±7.55)points,(70.53±8.75)points,(56.21±7.23)points,and(54.26±9.47)points in the control group(P<0.05).The com-pliance rate of patients in the observation group was 95.00%,which was significantly higher than 76.09%in the control group(P<0.05).Conclusion The application effect of quality control nursing by the joint special quality control team of medical staff and nurses in the care of patients undergoing maintenance hemodialysis is significant,which can effec-tively improve the adequacy of dialysis,upgrade the dialysis quality indicators,alleviate negative emotions such as anxi-ety and depression,improve compliance and quality of life,and is worthy of clinical promotion and application.