目的 构建并实施消化内科护理质量监测指标,提高专科护理质量.方法 通过成立研究小组,基于消化内科专科特点以查阅文献及头脑风暴法,根据消化内科历年来收治的前5种疾病,从专科护理操作、疾病并发症、患者安全等方面,结合以往护理质量中存在的主要问题进行详细分析,制订消化内科6项专科护理质量监测指标,即消化内镜患者术前准备落实率、呕血患者窒息发生例数、鼻胆(胰)管引流堵管率、腹泻患者肛周皮肤损伤发生率、禁食患者低血糖发生率、疼痛管理的满意度.明确指标的关键内容和科学测量方法,通过回顾性分析分别比较2014、2015、2016年6项监测指标结果.统计学方法采用χ2检验.结果 2015年除呕血患者窒息发生例数未发生改进外,其余5项指标与2014年相比均有改进,差异均有统计学意义(χ2值分别为34.710、9.223、7.834、5.547、32.899;P<0.05).2016年6项监测指标数据均较2015年得到改善,差异均有统计学意义(χ2值分别为102.334、5.496、4.257、3.953、39.191、192.910;P<0.05).结论 建立消化内科护理质量监测指标,制定有针对性的护理措施,有目的性对专科护理质量展开持续改进,能积极提升护理质量管理水平.%Objective To construct and implement the gastroenterology nursing quality monitoring index, and to improve the quality of nursing in the specialty. Methods A research team was formed to analyze the major problems in nursing quality according to the top 5 diseases in gastroenterology department. The research process was based on the characteristics of gastroenterology, focusing on nursing operating skills, diseases and complications and patient safety, in the methods of literature review and brain storm. Finally, a total of 6 specialist nursing quality monitoring indicators were established: the implementation rate of digestive endoscopy preoperative preparation, the incidence of hematemesis asphyxia, the plugging rate of nasal biliary (pancreatic) drainage; the incidence of perianal skin injury in diarrhea patients; the incidence of hypoglycemia in fasting patients and the satisfaction of pain management. The key content and scientific measurement of the indicators were clarified by retrospectively analyzing and comparing 6 monitoring indicators between 2014 and 2015, 2015 and 2016 respectively. The statistical methed used was χ2test. Results In 2015, all the indicators improved except the incidence of hematemesis asphyxia than those in 2014, and the differences were statistically significant (χ2=34.710,9.223,7.834,5.547,32.899;P<0.05). In addition, all the 6 indicators improved than those in 2015, and the differences were statistically significant (χ2=102.334,5.496,4.257, 3.953,39.191,192.910;P< 0.05). Conclusions The establishment of gastroenterology nursing quality monitoring indicators, the development of targeted care measures, and the continuous improvement in the quality of specialist nursing can improve the quality of nursing management.
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