运用PDCA提高肿瘤手术患者肠外营养医嘱合理率

Improvement of Reasonable Rate of Doctor's Advice on Parenteral Nutrition in Patients with Tumor after Surgery by using PDCA

目的 :对肿瘤切除手术患者肠外营养医嘱不合理情况及时干预及事后点评反馈后,提高医嘱合理率,减少患者术后并发症以及降低患者住院天数。方法:运用PDCA,对干预前(2015年)及干预后(2016年)的数据进行对比分析。结果:通过干预前及干预后的数据进行对比分析发现,医嘱合理率从80%上升至98%,患者并发症发生率从11.17%下降至2%(P=0.002),平均住院天数从21天下降至18天(P=0.014),干预有效。结论 :持续质量改进方法 PDCA可以运用至临床科室日常工作中,提高患者医疗安全,降低患者的医疗负担,提高医院的整体服务满意度。

Objective:After comment feedback, the unreasonable doctor's advices on parenteral nutrition in patients with tumor after surgery were intervened timely to decrease the postoperative complications and shorten the time for hospitalization. Methods:The date before(2015) and after(2016) intervention were compared and analyzed by using PDCA. Results:The reasonable rate of doctorpre-intervincreased from 80% before intervention to 98% after intervention, while the incidence of complications decreased from 11.17% to 2%(P=0.002), and average length of hospital stay decreased from 21 d to 18 d(P=0.014). The results proved that the intervention was effective. Conclusion:Continuous quality improvement method PDCA may be applied to the daily work of clinical departments so as to improve the medical safety, reduce the patient daily work of clinical departmentsatisfaction degree of patients to overall service of the hospital.