摘要
目的探讨持续质量改进模式在人工气道湿化中的应用效果。方法选择2016年1—6月我院综合性ICU收住的气管插管患者34例为对照组,选择2016年7—12月收治的气管插管患者37例作为观察组。对照组采取人工气道的常规护理方法。观察组采用FOCUS-PDCA模式,找出人工气道患者在临床护理中影响气道湿化效果的薄弱环节并分析原因,实施整改方案,比较两组患者气管插管期间气道湿化效果、痰痂发生例数、护士吸痰、翻身拍背操作规范性,医生每日评估拔管落实率。结果观察组24小时气道湿化满意率为86.5%,高于对照组的52.9%,72小时气道湿化满意率为81.1%,高于对照组的55.9%,组间数据对比,差异具有统计学意义(P<0.01);观察组护士吸痰操作得分为(92.3±2.14)分,翻身拍背得分为(95.1±3.12)分,均高于对照组(81.4±2.23)分,(82.1±1.13)分,差异具有统计学意义(P<0.05);观察组医生每日评估拔管落实率为100%,高于对照组的47.1%,差异具有统计学意义(P<0.01)。结论 FOCUS-PDCA模式的应用提高人工气道湿化满意率,防止痰痂形成,确保患者安全;同时提高护士规范操作能力和医生每日评估拔管落实率,使患者能及时拔除气管插管,利于早日康复。
Objective To investigate the effect of continuous quality improvement model on humidification of artificial airway. Methods 34 cases of patients with tracheal intubation received comprehensive ICU in our hospital from January to June 2016, were selected as control group, 37 cases of patients with tracheal intubation in our hospital from July to December 2016 were selected as the observation group. The control group adopted routine nursing method of artificial airway, the observation group was treated with FOCUS-PDCA mode, to find out the weak link of the effect of airway humidification in patients with artificial airway in clinical nursing and to analyze the causes, to implement rectification plan. During the comparison of two groups of patients with tracheal intubation airway humidification, sputum cases, nurse suction, turning back the normative operation, doctors daily assessment of the implementation rate of extubation. Results The satisfaction rate of 24 hours airway humidification in the observation group was 86.5%, which was higher than 52.9% in the control group. The satisfaction rate of 72 hours airway humidification was 81.1%, which was higher than 55.9% of the control group, the difference between the two groups was statistically significant(P < 0.01); The observation group nurses suction operation score(92.3 ± 2.14) points, turning back to score(95.1 ± 3.12) points, which were higher than the control group(81.4 ± 2.23) points,(82.1 ± 1.13) points, the difference was statistically significant(P < 0.05); The implementation rate of extubation in the observation group was 100%, which was higher than that of the control group(47.1%), the difference was statistically significant(P < 0.01). Conclusion The application of FOCUS-PDCA mode can improve the satisfaction rate of artificial airway humidification, to prevent sputum scab formation and ensure patient safety. At the same time, improve the standard operation ability of nurses and doctors daily evaluation of extubation implementation rate, so that pat
出处
《中国继续医学教育》
2017年第25期128-130,共3页
China Continuing Medical Education
