PDCA循环在提高医辅人员初级心肺复苏认知度中的应用

摘要

Objective To explore the effect of PDCA [plan (P), design (D), check (C), act (A)] cycle on primary cardiopulmonary resuscitation (CPR) training for medical assistants in hospitals. Methods PDCA cycle was used to enhance continuous quality improvement (CQI) of team members to carry out brain storming to find out the root causes of the training difficulty, and directing to the 3 main root causes: lack of emergency rescue consciousness, without systematic training system and improper education procedure, it was proposed to arrange 3 great strategies: emergency rescue knowledge training, design of systematic training system and proper arrangement of training process. The changes of medical assistants' subjective willingness to perform the first aid, the accurate rates of answering questions on CPR location, frequency, depth, ratio of compression to breathing and awareness degree of CPR before and after training were observed. Results After training, the medical assistants' subjective willingness to perform the first aid was higher than that before training [91.7% (121/132) vs. 2.3% (3/132), P＜0.05]. The accurate answer rates on questions concerning CPR basic knowledge, such as location, frequency, depth and compression-breathing ratio had been greatly improved after training compared with those before training [location: 65.2% (86/132) vs. 4.5% (6/132), frequency: 40.2% (53/132) vs. 0 (0/132), depth: 90.2% (119/132) vs. 0 (0/132), compression-breathing ratio: 84.8% (112/132) vs. 1.5% (2/132 ), all P＜0.05]. After training, the percentage of medical assistants having very familiar awareness degree of CPR was significantly higher than that before training [65.2% (86/132) vs. 3.0% (4/132), P＜0.05]. Conclusion Via CPR training PDCA cycle, not only the efficiency of CPR training management is greatly improved, but also the training effect of participants is significantly elevated.%目的 观察PDCA循环〔即计划(plan,P)、设计(design,D)、检查(check,C)、修正(act,A)〕对医院医辅人员心肺复苏(CPR)培训的影响.方法 选择佛山中医院从事医辅服务的工勤人员,采用PDCA循环带动质量持续改进(CQI)活动小组人员进行头脑风暴,寻找CPR培训困难的的根因,并针对缺乏急救意识和系统的培训体系以及培训流程不完善三大根因,提出急救知识的培训、设计系统培训体系和完善培训流程三大对策.观察培训前后医辅人员急救主观意愿,对CPR按压部位、频率、深度、按压呼吸比回答正确率,以及对CPR知晓程度的变化.结果 培训后医辅人员进行现场处理的意愿较培训前明显提高〔91.7%(121/132)比2.3%(3/132),P＜0.05〕.培训后医辅人员对CPR按压部位、频率、深度、按压呼吸比回答正确率较培训前提高〔部位:65.2%(86/132)比4.5%(6/132),频率:40.2%(53/132)比0(0/132),深度:90.2%(119/132)比0(0/132),按压呼吸比:84.8%(112/132)比1.5%(2/132),均P＜0.05〕.培训后医辅人员对CPR知晓程度为非常熟悉的比例较培训前明显提高〔65.2%(86/132)比3.0%(4/132),P＜0.05〕.结论 通过PDCA循环,不仅明显提高了CPR培训管理的效率,还能明显提高培训效果.