品管圈活动在降低会阴Ⅲ度裂伤发生中的应用

摘要

Objective To explore the effect of quality control circle ( QCC) in reducing the incidence of third-degree perineal tear during vaginal birth.Methods Analysis was conducted on the clinical data of patients with third-degree perineal tear during vaginal birth in department of obstetrics in Beijing Tiantan Hospital.Ten staff in the department volunteered to set up QCC to investigate current status, analyze causes, set up aims, execute strategies, check effect and consolidate measures for improving related quality.Results Before conducting QCC the rate of third-degree perineal tear during vaginal birth because of unskilled delivery technique and too strong labor force was 83.33%.After performing QCC, it decreased from 2.88 % to 1.22% during July to December 2014, and the difference was significant(χ2 =1.931,P=0.04).Conclusion Application of QCC can reduce the rate of third-degree perineal tear during vaginal birth and enhance the professional knowledge and skills of the midwives.%目的：探索品管圈活动在经阴道分娩过程中降低会阴Ⅲ度裂伤发生中的应用效果。方法通过对2014年北京天坛医院产科经阴道分娩发生会阴Ⅲ度裂伤患者的临床资料进行分析，产科10名医护人员自愿成立品管圈，通过现状调查、原因分析、设定目标、对策实施、效果检查及巩固措施等程序，开展品管圈活动，进行相关质量改进。结果品管圈实施前，助产技术不熟练、产力过强导致的会阴Ⅲ度裂伤占83．33％；通过此次品管圈活动，在2014年7至12月产房的会阴Ⅲ度裂伤发生率由品管圈实施前的2．88％降至1．22％，差异具有统计学意义（χ2＝1．931，P＝0．04）。结论品管圈活动应用在产房经阴道分娩患者中，可有效降低会阴Ⅲ度裂伤的发生，同时增强了助产士的专业知识和管理能力。