PDCA循环管理提升ICU患者非计划性拔管安全的效果研究

摘要

Objective To investigate the effect of PDCA cycle management in unplanned extubation in ICU patients.Methods 150 hospitalized patients indwelling endotracheal intubation in comprehensive ICU before the implementation of PDCA management (from January 2013 to June 2014) were retrospectively analyzed.150 hospitalized patients indwelling endotracheal intubation in comprehensive ICU from July 2014 to December 2015 were selected as observation group,received total quality management of PDCA circulation mode.Nursing quality management and continuous improvement team was set up in our department,investigated and analyzed unplanned extubation incident in ICU patients with PDCA cycle management system,made a management cycle of plan-quality improvement problems-implementation-check-processing.Results The satisfaction degree of patients and their families in observation group was significantly higher than that in control group (96.7％ vs.86.7％,P＜0.05).The incidence of unplanned extubation in observation group was significantly lower than that in control group (1.33％ vs.8.67％,P＜0.05).Conclusion PDCA cycle management mode can effectively reduce the incidence of unplanned extubation in ICU patients,improve the safety and satisfaction degree of patients,improve the level of nursing management.%目的 探讨PDCA循环管理在ICU患者非计划性拔管的效果.方法 对实行PDCA管理前(2013年1月至2014年6月)综合ICU监护室留置气管插管的住院患者150例(对照组)进行质量回顾性分析;2014年7月至2015年12月综合ICU监护室留置气管插管的住院患者150例为观察组,应用PDCA循环模式进行全面质量管理,科室成立护理质量管理与持续改进小组,运用PDCA循环管理体系对ICU患者非计划性拔管事件进行调查分析,制定计划、确定质量改进问题、实施、检查、处理的管理循环.结果 观察组患者及家属满意度(96.7％)明显高于对照组(86.7％),差异有统计学意义(P＜0.05).实行PDCA管理前,对照组发生非计划性拔管患者13例(8.67％);实施后观察组发生非计划性拔管患者2例(1.33％),两组比较差异有统计学意义(P＜0.05).结论 PDCA循环管理模式,有效降低ICU患者非计划性拔管的发生率,提升患者安全和满意度,提高护理管理的水平.