基于PDCA循环护理管理在消化内镜清洗消毒中的应用效果

Applicative Efficacy of Nursing Management Based on PDCA Circulation in the Process of Cleaning and Sterilization of Digestive Endoscopy

目的探讨基于PDCA循环护理管理在消化内镜清洗消毒中的应用效果。方法选取2017年1月至2018年12月于广州市白云区妇幼保健院消化内科接受内镜诊治的600例患者作为研究对象,实施PDCA前的300例为对照组,实施后的300例为观察组。比较实施前后护理人员内镜清洗消毒执行情况、内镜清洗质量、患者不良事件及感染发生情况。结果观察组在使用内镜后正确进行床旁清洗,能正确做到螺旋、错位刷洗,洗液、清洗刷做到一镜一换等9个条目的执行情况均显著优于对照组(均P<0.05)。观察组内镜清洗操作规范、消毒防护措施落实、清洗消毒记录完整及生物学检测结果合格情况均明显优于对照组(均P<0.05)。观察组患者呛咳、躁动及其他不良事件发生率均显著低于对照组(均P<0.05)。结论基于PDCA循环护理管理能有效改善护理人员对消化内镜清洗消毒的执行情况,有利于降低患者不良事件发生率,提高消化内镜清洗消毒质量。

Objective To explore the application efficacy of PDCA-based circulatory nursing management in cleaning and disinfection of digestive endoscopy.Methods From January 2017 to December 2018,600 patients received endoscopy treatment in the Department of Gastroenterology,Baiyun District Maternal and Child Health Hospital of Guangzhou City were selected as the research objects,300 patients before the PDCA implementation were the control group,and 300 patients after the PDCA implementation were the observation group.Implementation of endoscopy cleaning and disinfection and quality of endoscopy cleaning of the nurses,as well as adverse events and incidence of infection of the patients before and after the implementation were compared.Results The implementations of 9 items including correct bedside cleaning after using the endoscopy,conducting correct spiral and malposed cleaning,replacement of cleaning lotion and brush after each use,etc of the observation group were significantly better than those of the control group(P<0.05).The situations of standardized cleaning operation,sterilization and prevention measures’implementation,full records of cleaning and sterilization and qualified results of biological examination of endoscopy in the observation group were significantly better than those in the control group(P<0.05).The incidence of cough,dysphoria and other adverse events of the observation group was significantly lower than that of the control group(P<0.05).Conclusion The nursing management based on PDCA circulation can effectively improve the executive conditions of cleaning and sterilization of digestive endoscopy in nurses,which will reduce patients’incidence of adverse events,and promote the quality of cleaning and sterilization of digestive endoscopy.