Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

Application effect of quality control circle in postoperative functional exercise compliance of breast neoplasms patients:a meta-analysis

Background:Good adherence to post-operative exercise is crucial for long-term exercise intervention programs aimed at improving compliance,motivation for functional exercise,and quality of life among breast cancer patients.This study aims to evaluate the application effect of quality control circles on postoperative functional exercise compliance in breast neoplasm patients.Methods:A comprehensive search was conducted in CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Web of Science and CINAHL databases from their establishment to May 06,2023.Manual search and backtracking of relevant literature were also conducted.The search terms included a combination of subject terms and free words.Meta-analysis was performed using RevMan 5.4 software on eligible literature.Results:Initially,517 papers were retrieved,and after removing duplicates 238 papers using NoteExpress software,279 titles and abstracts were reviewed.Subsequently,225 non-compliant papers were excluded,leaving 54 full texts to be read.After excluding 38 non-compliant papers,16 eligible papers were included for Meta-analysis.These papers comprised a total of 1,342 patients(679 in the test group and 663 in the control group).The heterogeneity test using a fixed effects model showed P=0.22 and I2=21%.The Meta-analysis results demonstrated that the implementation of quality control circles alongside usual care significantly improved compliance with postoperative functional exercise in breast cancer patients(odds ratio=6.68,95%confidence interval(4.97,8.98),P<0.00001).Conclusion:Quality control circles activities can effectively enhance compliance with post-operative functional exercise among breast cancer patients,aiding in the recovery of affected limb function,improvement of self-care ability,and early reintegration into society and normal life,thereby enhancing quality of life.It is important to continually accumulate experience in applying relevant quality control circles activities in clinical work and promptly enhance the level of care accordingly,as the functional exercise of breast cancer patients after surgery involves a long-term and gradual improvement process.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

Analysis of the Effect of Quality Control Circle on the Central Sterile Supply Department

Objective:To analyze the effect of quality control circle on the central sterile supply department(CSSD).Methods:The control group and the observation group each consisted of 180 instruments received by the sterilization supply center from January to March 2023 and 11 CSSD staff.The control group underwent routine management while quality control circle was implemented in the observation group.The quality of work,disinfection and sterilization qualification rates,disinfection and sterilization of various instruments,cleaning indicators,and management satisfaction of both groups were compared.Results:The observation group scored higher in terms of work quality,the qualification rate of disinfection and sterilization in each link,the disinfection and sterilization of instruments,and cleaning indicators compared to the control group.Besides,the management satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:A quality control circle ensures the quality of work,improves the cleaning,disinfection,and sterilization of instruments of the CSSD,and improves the management satisfaction of the CSSD staff.

Application of Quality Control Circle Activity in Improving Effectiveness of Drug Intervention in Lung Cancer Patients with Moderate to Severe Pain

Objective:Lung cancer has the highest incidence and mortality of all malignant tumors in China.Cancer pain dramatically affects patients’comfort level,causing insomnia,anorexia,anxiety,fear,depression,and a decline in the quality of life(QOL).The literature suggests a shortage of adequate cancer pain management for 59.1% of patients in China.The quality control circle(QCC)activity reflects the people-oriented core idea of management.This study aimed to assess the efficacy of QCC in enhancing the effectiveness of drug interventions in lung cancer patients with moderate to severe pain.Methods:From January 2019 to July 2019,lung cancer patients with moderate to severe pain were treated with drugs.The total number of drug interventions was 3072.A QCC activity was performed following the ten steps of the plan-do-check-act(PDCA)model.The reasons for the poor effectiveness of drug intervention in lung cancer patients with moderate to severe pain were analyzed.Countermeasures were designed to improve the effectiveness of drug intervention,including setting up a pain college,writing a medication education manual,and formulating operational rules for the administration of narcotic drugs.The effectiveness of drug intervention in lung cancer patients with moderate to severe pain and activity ability scores of QCC members were analyzed statistically before and after QCC activity.The effectiveness of drug intervention was investigated and compared before and after establishing the QCC.Results:After establishing the PDCA model,the effectiveness of drug intervention for moderate to severe pain in lung cancer patients increased from 56.28% to 85.29%.Members had significant improvement in problem-solving ability,responsibility,communication,coordination,self-confidence,team cohesion,enthusiasm,QCC skills,and harmony.Conclusion:QCC activity can significantly improve the efficiency of drug intervention in lung cancer patients with moderate to severe pain and their quality of life.

Application of a Quality Control Circle to Reduce the Wait Times between Continuous Surgeries

Purpose: To investigate how to shorten patient wait times between continuous ocular operations and to evaluate the influence of a quality control circle(QCC) on operating room management.Methods:.QCC management was established to conduct activities..Clinical data were collected to analyze the causes of long wait times between continuous surgeries. Effective measures were undertaken correspondingly.Results:.The staff from QCC actively undertook measures that would significantly shorten patient wait times between continuous ocular surgeries(P<0.05).Conclusion:.Multiple measures,.such as setting up a QCC,enhancing the arrangement of surgical procedures,.establishing effective communication channels,.optimizing human resources, and integrating the use of instruments, can effectively shorten patient wait times between continuous vitreous or retinal surgeries.

Reducing the Error Rate of Drug Delivery in Hospital Pharmacies: From the Angle of Pharmacy Quality Control Circle

Objective To explore the effect of applying pharmacy quality control circle to reduce the error rate of drug delivery in inpatient pharmacy,and to improve the service quality of inpatient pharmacy staff.Methods According to the ten standardized steps of pharmaceutical product management and Gantt chart,fishbone diagram and Plato were used to analyze the causes of drug delivery errors in hospital pharmacies,to find countermeasures and confirm the implementation effect.Results and Conclusion The error rate was reduced from 52% before implementation to 27.8%,and the target achievement rate was 100%.The staff’s understanding and application ability of pharmaceutical product circle was further enhanced.The “Training Standard for Newcomers” has reference value for hospital inpatient pharmacies and it can be promoted continuously.Pharmaceutical quality control circle can improve the quality of pharmacy services in hospitals.

Reducing the Internal Difference Error Rate in Hospital Pharmacies:From the Angle of Quality Control Circle

Objective To improve the management level of pharmacy dispensing center,reduce dispensing errors and promote the safety of drug use.Methods Hospital pharmacies could be managed according to the theory of quality control circle(QCC).Based on the ten steps of QCC,the internal difference error rate in pharmacies could be reduced.Results and Conclusion The error rate of pharmacies was reduced from 2.74‰to 0.57‰,and the goal achievement rate was 108.466.Besides,the progress rate reached 84.82%.The abilities of circle members were improved,and the operation of pharmacy was more standardized.The activity of QCC is helpful to reduce the internal difference error rate,improve the operation level of pharmacy and ensure the safety of drug use.

Use of Quality Control Circles-A Fad or Need

Different techniques including Quality Control Circles, Business Process Reengineering and Statistical Process Control （SPC）, Total Quality Management have been in use to reduce waste in the industry. Waste is considered as necessary evil and there are many types of waste in the industry. There are many ways and means to reduce waste but the less costly is to use Quality Control Circles technique effectively and efficiently. In quality control circles human resources that consist of small groups of employees are selected, who voluntarily meet at regular intervals to identify, analyze and solve quality and other problems in their work areas. In the Quality Control Circles different techniques of the quality improvement and total quality management are utilized which could be numeric or nonnumeric such as statistical quality control techniques and fish bone diagram or brain storming respectively. This article discusses that how reduction of waste in Pakistan industry is possible by using Quality Control Circles implementation.

The Application of Quality Control Circles to Reduce the Cost of Non-priced Consumables in Department of Oncology

Objective:To investigate the effectiveness of using quality control circle(QCC)techniques to reduce the cost of non-priced consumables in medical oncology.Methods:Analytic statistics were compiled on the performance appraisal form.Aiming at the key points of improvement with respect to the excess cost of non-valuable consumables,the reasons were analyzed,and corresponding measures were formulated to compare the cost before and after the improvement.Results:After the QCC activity,the cost of non-priced consumables decreased from RMB 6.57/bed day to RMB 3.96/bed day.Conclusion:QCC has effectively reduced the cost of non-priced consumables in the oncology department,and it is worthy of promotion.

Empirical Study on Improving Customer Satisfaction of Retail Pharmacies by Using Quality Control Circle

Objective To study the effect of quality control circle(QCC)activities on customer satisfaction of retail pharmacies so as to improve the level of customer management.Methods After choosing the theme of improving customer satisfaction research(CSR)in pharmacies,Gantt chart,questionnaire,fishbone diagram and other tools were applied in the“endeavor circle”to find out the factors affecting the theme.Then corresponding countermeasures were made and implemented to verify them in different stages.Meanwhile,the radar map and other technologies were used to compare the changes of CSR and circle members’growth before and after the activities.Results and Conclusion Sales clerk’s lack of drug knowledge,serious shortage of drugs,incapability of establishing a good relationship with customers and the lack of after-sales service were identified as the main factors.After implementing corresponding countermeasures,the target achievement rate was 116.12%,and the progress rate was 19.02%.Besides,customer satisfaction increased from 79.54%to 94.67%and the team growth value of circle members increased from 3.29 to 5.83,with significant tangible and intangible effects.QCC activities in retail pharmacies can not only standardize pharmaceutical service mode,but also improve the overall competence of sales clerks.The key factors and management methods for CSR improvement obtained from QCC activities will provide reference for the customer management of retail pharmacies.

课题研究型品管圈在早产儿经口胃管置入管理模式中的应用

目的探讨课题研究型品管圈活动在构建早产儿经口胃管置入管理模式中的应用价值。方法选取2020年1月至2022年12月该院需行经口胃管置入的280例早产儿,以品管圈活动前(2020年1月至2021年12月)收治的180例早产儿为对照组,实施品管圈活动后(2022年6-12月)收治的100例早产儿为观察组。比较2组胃管前端一次性到位率及恶心、呕吐发生率,分析品管圈活动前后圈员综合素质评分。结果2组胃管前端一次性到位率比较,差异有统计学意义(P<0.05),而恶心、呕吐发生率比较,差异无统计学意义(P>0.05)。观察组品管圈活动目标达成率110.9%。品管圈活动后,圈员综合素质评分较活动前得到不同程度的提升,其中品管手法及创新精神能力评分得到明显提高。结论基于课题研究型品管圈活动构建的早产儿经口胃管置入管理模式,能够有效提高早产儿经口胃管前端一次性到位率,降低置管相关并发症发生率。

品管圈在提升低于3岁住院患儿雾化吸入依从率中的应用

目的探讨品管圈(Quality Control Circle,QCC)管理方法在提高住院患儿雾化吸入依从率的应用价值。方法济宁市第一人民医院儿科雾化吸入QCC管理实施时间自2020年6月开始,选取QCC实施前(2020年4月至2020年5月)0~3岁住院进行雾化吸入治疗的患儿454人以及QCC实施后(2020年11月至12月)0~3岁住院进行雾化吸入治疗的患儿496人进行研究,比较两组住院患儿在雾化吸入治疗中的哭闹发生率、按时雾化率、家属拒绝情况、雾化中断情况,以及总体雾化依从率。结果在QCC实施后,0~3岁住院患儿雾化吸入哭闹发生率下降(23.33%vs 5.04%)、未按时雾化率下降(16.08%vs 2.82%),总体雾化依从率提升(56.00%vs 88.90%),差异有统计学意义(P<0.001);QCC实施后患儿家属满意度评分提升(t=5.95,P<0.001)。结论实施QCC能够提升低于3岁住院患儿雾化吸入依从率,提升患者家属满意度。

品管圈活动在降低内镜黏膜切除术术后48 h内低血糖发生率中的应用效果

目的探讨品管圈活动在降低内镜黏膜切除术(EMR)术后48 h内低血糖发生率中的应用效果。方法回顾性选取2023年4月至9月在首都医科大学附属北京世纪坛医院消化内科住院行EMR的胃肠息肉患者600例作为研究对象。将未实施品管圈(2023年4月至6月)的325例患者作为对照组,将实施品管圈(2023年7月至9月)的275例患者作为观察组。对照组按照常规护理进行管理,观察组在对照组的基础上开展品管圈活动。比较两组患者EMR术后48 h内低血糖的发生率及影响因素、生命质量评分的差异,分析开展品管圈活动在降低ERM术后48 h内低血糖中的实践成果。结果观察组低血糖发生率为4.4%,明显低于对照组(10.8%),差异有统计学意义(P<0.05)。影响低血糖发生率的因素中,观察组输液不合理、摄入不足的患者比例分别为0.7%、1.5%,均低于对照组(4.3%、4.9%),差异均有统计学意义(P<0.05)。干预后,观察组患者生理功能、生理职能、躯体疼痛、一般健康状况、心理健康、精力、社会功能、情感职能评分分别为(86.94±7.32)、(84.18±7.03)、(83.00±5.96)、(82.91±6.39)、(80.42±6.11)、(78.45±7.35)、(82.69±6.72)、(80.71±6.17)分,均明显高于对照组[(81.77±11.67)、(78.09±10.97)、(76.50±9.64)、(76.75±9.86)、(75.80±7.30)、(72.38±9.97)、(76.86±9.97)、(75.94±7.61)分],差异均有统计学意义(P<0.05)。通过此次品管圈活动,圈员们在品管圈手法掌握程度、发现问题能力、个人素质、责任心、组织协调能力、自信心、团队合作精神等方面都取得了进步。结论通过开展品管圈活动,规范了EMR的护理流程,降低了EMR术后48 h内低血糖的发生率,提升了护理人员的专业知识水平、品管圈的手法运用能力和团队协作及质量管理能力。

降低颈椎前路手术患者术后咽部不适发生率的品管圈实践

目的 探讨品管圈活动在降低颈椎前路手术(ACSS)患者术后咽部不适发生率中的应用效果。方法 以2023年1~2月中山大学附属第八医院未开展品管圈活动的76例ACSS患者为对照组,2023年3月开展品管圈实践的76例ACSS患者为观察组,比较两组术后咽部不适发生率的差异。结果 对照组和观察组术后咽部不适发生率分别为63.16%和27.63%,观察组目标达成率为96.81%,改善幅度为56.25%;与对照组比较,观察组术后第一次下地时间和住院时间更短,平均住院费用更低(P <0.05)。圈员综合能力各维度评分均较品管圈活动前有所上升。结论 品管圈活动规范和优化ACSS围手术期管理制度和流程,提升护理人员的综合能力,有效降低ACSS术后咽部不适发生率,加速患者康复进程。

多学科协作品管圈提升静脉用药调配中心处方前置审核质量实践与效果

目的提升静脉用药调配中心(PIVAS)处方前置审核的质量,促进合理用药。方法由PIVAS审方药师-临床医师-护师-行政管理人员组建多学科协作品管圈(QCC),以“提高PIVAS不合理处方干预成功率”为主题开展活动,按活动步骤分析影响PIVAS不合理处方干预成功率的真因,拟订并实施相应对策,比较QCC活动开展前后的有形成果及无形成果,评价活动的开展效果。结果用药处方标准化、开展科室巡讲培训、完善处方审核标准、改进处方干预的沟通模式、加强药师培训等措施可有效干预不合理处方,为有效对策;PIVAS不合理处方干预成功率由QCC活动前的34.71%升至87.72%,升幅达152.72%;PIVAS处方不合理率由1.02%降至0.57%,降幅达44.12%。结论开展多学科协作QCC活动可有效提高PIVAS不合理处方的干预成功率,提升PIVAS处方前置审核质量,促进临床合理用药。

品管圈活动护理应用于预防ICU昏迷患者鼻饲误吸发生的效果

目的:探讨品管圈(QCC)活动护理在应用于预防ICU昏迷患者鼻饲误吸发生的效果.方法:选取2018年6月—2020年5月天津市天津医院ICU收治的301例ICU昏迷鼻饲患者为研究对象,将2019年5月作为我院ICU实施QCC活动护理的分界线,2018年6月—2019年5月收治的135例患者作为对照组,采用常规ICU护理;2019年6月—2020年5月收治的166例患者作为观察组,采用QCC活动护理.由11名ICU护士组成QCC活动组,比较2组的护理效果.结果:实施QCC活动后,ICU昏迷患者鼻饲误吸发生率由活动前的5.32%下降到0.54%,改善幅度为89.8%,目标达成率为184%.结论:品管圈活动能有效提高医院住院部护理质量,大幅降低ICU昏迷鼻饲患者的误吸风险.

品管圈管理在静脉用药调配中心的应用效果

目的:观察品管圈管理在静脉用药调配中心(PIVAS)的应用效果。方法:选取2020年1—12月该院PIVAS的46名护士作为对照组,实施常规管理;另选取2021年1—12月该院PIVAS的46名护士作为观察组,实施品管圈管理。比较两组配药安全知识知晓率、药物配制差错率和药物配送时间延长率。结果:观察组药物配置流程、药物配伍禁忌、药物剂量换算、用药前正确评估患者、药物输注流程、输注时观察要点等配药安全知识知晓率均高于对照组,差异有统计学意义(P<0.05);观察组药物配置差错率为0.48%(12/2500),低于对照组的2.32%(58/2500),差异有统计学意义(P<0.05);观察组药物配送延长率为0.36%(9/2500),低于对照组的2.48%(62/2500),差异有统计学意义(P<0.05)。结论:品管圈管理应用于PIVAS可提高配药安全知识知晓率,以及降低药物配制差错率和药物配送时间延长率的效果优于常规管理效果。

品管圈活动提高门诊哮喘患儿用药依从率应用效果分析

目的探索品管圈对门诊哮喘患儿用药依从率的应用效果。方法成立品管圈(2022年2~8月),以“提高门诊哮喘患儿用药依从率”为主题,运用质量管理工具开展活动。结果实施品管圈活动后,门诊哮喘儿童用药依从率由45%提高至72.5%,完成设定目标;患者满意度由92%提高到98%,健康教育知晓率由86%提高到98%;圈员们在解决问题能力、品管手法、沟通协调能力较前大幅上升。结论品管圈活动可有效提高门诊哮喘患儿用药依从率,同时能完善相关制度和流程,药师在专业能力及职业素养方面得到全面提升。

品管圈活动对腔镜手术器械报损率的影响研究

目的 探索应用品管圈手法对腔镜手术器械报损率的影响效果。方法 组建多部门联合的品管圈小组,选定“降低腔镜手术器械的报损率”为主题,选取改善前2022年8—10月复用腔镜手术器械3520件,其报损率2.33%,以其损坏类型作为研究对象,分析器械部件缺失和内芯、外鞘、手柄混淆的现状,进行解析并制定对策,应用愚巧法改进培训方案、创建“四点式”腔镜手术器械保养流程方法、修订细化查检表等措施。选取改善后2022年11月至2023年2月腔镜手术器械5213件为研究对象,研究其报损率来分析此次改善措施的效果。结果 改善后5213件腔镜手术器械的报损率降低至0.27%,差异有统计学意义(P<0.001),目标达成率为137.33%。对处理流程中的8种问题类型的两组数据进行比较,改善后均低于改善前,差异有统计学意义(P<0.001)。品管圈实施后,圈成员的品管圈手法、团队合作能力、沟通能力、责任心、专业能力、解决问题能力都有一定程度提升。结论 通过品管圈活动在降低腔镜手术器械报损率的同时,科学应用管理工具多部门联动规范工作流程、制定器械报损的评分标准可以落实手供同行评议督查模式,保障医疗器械使用安全,值得应用推广。