目的 探讨提高临床护理质量的管理方法。 方法 利用归因理论，对2009年12月－2010年11月护理部3级综合质量检查、午夜间及节假日2级护理质量检查、科室1级护理质量自查存在的128项问题进行回顾性归因分析。 结果 危重患者护理、病房规范化管理、5年内护士、午间时段为扣分项目多发点。 结论 护理人力资源合理配置、质控归因分析会、低年资护士培训、抓重点时间段、注重人性化管理等有望改变现状。
Objective To explore the application effects of nursing quality control mode based on nurse satisfaction. Methods A total of 226 nurses in 12 nursing units were selected from December 2013 to June in 2014 as the study subjects. Then, we compared the nurse satisfaction, patient satisfaction, and the effect of nursing quality control before and after the implementation of quality control mode in which nurses participated actively. Results After a half-year practice of nursing quality mode, all the investigation items of the project were significantly different from those before the mode application (P>0.05), except Q1, Q2, Q8, and Q10 in the nurse satisfaction questionnaire, q1, q2, q3, q4, and q14 in the patient satisfaction questionnaire, and quality of emergency management in the nursing quality control section. Conclusion Application of nursing quality control mode can fully mobilize the enthusiasm of nurses, improve nurse satisfaction and the effect of nursing quality management, which has a high value of application in clinical nursing management.
Objective To review and analyze the statistics of laboratory critical values in the Department of Cardiovascular Surgery in order to improve the procedures of dealing with these values and provide references for the enhancement of the nursing level. Methods We retrospectively analyzed laboratory critical values of 236 inpatients in the Department of Cardiovascular Surgery from April 2013 to April 2014. General data of the patients including the type of critical values, the critical value, distribution, clinical processing time and complications related to the critical values. Results A total of 208 laboratory critical values of 185 inpatients were analyzed including abnormal blood potassium was involved in 99 (47.60%); abnormal blood glucose was involved in 13 (6.25%); abnormal blood sodium was involved in 11 (5.29%); abnormal blood troponin was involved in 13 (6.25%); and 72 cases had other kinds of critical values (34.62%). A total of 136 critical values were closely related to the Department of Cardiovascular Surgery. Among them, 60 cases had a processing time of 15 minutes or shorter. After re-examination, 16 were confirmed to be fake critical values; and 11 critical values did not need to be treated according to the condition of the patients. There were altogether 27 cases of complications related to critical values, including 23 cases of arrhythmia related to abnormal blood potassium, 2 cases of abnormal muscle strength caused by abnormal blood sodium, and 2 cases of hypoglycemia. After the critical values were handled, related complications disappeared without any recurrence. Conclusions Perfect regulatory regime and process of recording and handling laboratory critical values are important for nurses in our department to carry out more accurate measures in treating these critical values including abnormal blood potassium, blood glucose, blood sodium, and blood troponin, etc. In order to continuously improve medical and nursing quality, nurses should pay more attention to the identification and treatment of laboratory critical values.
摘要:目的:探讨接受超声引导下经直肠前列腺穿刺活检术(transretal prostatic biopsy,TPB)检查的临床护理相关问题,为前列腺穿刺活检临床护理提供参考。方法:通过心理疏导接解除者术前对TPB的恐惧心理,明确TPB是比较安全、可靠的、不可替代的检查方法,了解手术过程、护理方法和一般并发症,提高TPB的检查效果及护理质量。结果:71例患者进行TPB检查,全部患者均能主动配合检查操作,检查术中并发迷走神经心血管反射1例,术后并发血尿4例,短期内疼痛5例,均早期发现,给与相应的护理与治疗后治愈。结论:TPB是前列腺占位性病变患者有效的定性有创性检查方法,对行TPB检察患者患者应采取针对性的护理措施,提高护理质量及检查安全性。 Abstract: Objective: To investigate correlative nursing measure of patients with transretal prostatic biopsy (TPB) guided by ultrasound, provide reference for clinical nursing of TPB. Methods: We dismissed patient’s fear by psychological nursing, and explained that TPB was a safe, reliable and nosubstitutive checking, and help them understand procedure of operation, nursing measure and common complication, so as to improve effect of checking and quality of care. Results: Seventyone patients received checking with TPB, all patients could initiativiy go with checking, one patient took place pneumogastric nerve reflect, 4 patients take place hematuria postoperation, 5 patients feel soreness in shortterm. All complications were found in morning, and were cure by nursing and treatment. Conclusion: TPB is valid checking method to occupy lesion of prostate for qualitation. Because TPB is a traumatic operation, homologous nursing measure must be take to improve safety of TPB and quality of care.
Objective To explore the nursing quality standards of joint surgery based on “structure-process-outcome” three-dimensional quality evaluation model, and provide a reference for improving the quality of joint surgery nursing. Methods From March to July 2023, based on the “structure-process-outcome” three-dimensional quality structure model as the theoretical framework, combined with systematic literature review and semi-structured interviews, the quality standards of joint surgery specialist nursing were preliminarily formulated. The Delphi method was used for screening, demonstration, and correction, then the analytic hierarchy process was used to determine the weights. Results The recovery rates of the two rounds of expert letter consultation were 93.75% and 100.00%, respectively. The expert authority coefficients of both rounds were 0.95. The positive coefficients of experts in the two rounds were 0.93 and 1.00, respectively. The coefficients of variation after the second round of correspondence were 0-0.20. In the second round of correspondence inquiry, the Kendall harmony coefficients of primary standards, secondary standards and tertiary standards were 0.156, 0.115 and 0.285, respectively, with statistical significance (P<0.05). Finally, the quality standards of joint specialty nursing included 3 primary standards, 23 secondary standards and 99 tertiary standards. Conclusion The construction process of nursing quality standards of joint surgery specialty based on “structure-process-outcome” three-dimensional quality structure model is scientific and reliable, the index evaluation results are less volatile, and the opinions are concentrated, which can provide a basis for comprehensively, accurately and pertinently improving the quality of joint surgery specialty nursing.
目的:调查手术室实施持续质量改进(continuous quality improvement,CQI)对手术室护理工作质量、工作效率和医生、患者满意度的影响。方法:成立科室质量控制小组,全科护理人员均为责任人。根据手术室质量管理中存在的问题确立改进目标,实施CQI。质控小组定期监测及发放问卷调查并比较实施CQI前后手术室工作质量、工作效率及医生和患者的满意度。结果:实施CQI后,手术室的术前用药准备、术前平面清洁、术后整理、药品按序摆放、物品定位放置、仪器完好、器械清洗合格各项指标均较实施CQI前改善;手术等待时间缩短,手术总台次增加;医生和患者的满意度提高。结论:通过实施CQI,规范了护士的行为,提高了手术室的工作质量和工作效率,增加了医生和患者的满意度。