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目的探讨在急诊科护士交接班质量控制管理中应用PDCA循环法的效果。方法 2014年10月至2015年10月在我院急诊科护理交接班管理中应用PDCA循环法,通过规范交接班流程及护士的岗位绩效量化考核,加强交接班质控管理。观察PDCA实施前后的护理质量、急诊科室患者不良事件发生率及患者、医护满意度等情况。结果 PDCA循环法实施后基础护理(14.62±0.70)分、特级护理(14.48±0.61)分、病房(14.32±1.32)分、文书管理(14.52±1.21)分、急救药品和仪器管理(19.84±0.56)分、护理质量总评分(84.48±5.02)分显著高于实施前(13.56±1.10,13.40±1.12,13.46±1.05,13.52±1.05,18.40±1.32,78.58±8.23)分(P<0.05)。实施后患者住院期间管道脱出(0.40%)、给药错误(1.20%)、医嘱处理错误(0.40%)、护理纠纷事件(1.00%)显著低于实施前(3.60%,5.00%,2.40%,3.60%)(P<0.05),而患者满意率98.40%、医护满意率99%则高于实施前(84.00%,87%)(P<0.05)。结论 PDCA循环法能有效提高急诊科护理和交接班质量,提高护士执行力,降低患者不良事件的发生,有助于降低医疗纠纷事件,提高患者、医护满意率。
Objective To explore the effect of applying PDCA method in quality control management of emergency department nurses. Methods From October 2014 to October 2015, PDCA cycle method was applied in the management of emergency attendance of emergency department in our hospital from October 2014 to October 2015 to strengthen the quality control of delivery control by standardizing the procedure of shift-over and quantitative evaluation of job performance of nurses. Observe the quality of care before and after the implementation of PDCA, the incidence of adverse events in patients with emergency department and patients, health care satisfaction and so on. Results After the PDCA method was administered, the scores of basic nursing (14.62 ± 0.70), special care (14.48 ± 0.61), ward (14.32 ± 1.32), document management (14.52 ± 1.21), emergency medicine and equipment management (19.84 ± 0.56 ), The total score of quality of care (84.48 ± 5.02) was significantly higher than that before the implementation (13.56 ± 1.10, 13.40 ± 1.12, 13.46 ± 1.05, 13.52 ± 1.05, 18.40 ± 1.32, 78.58 ± 8.23) (P <0.05). During the hospitalization period, the patient was discharged from the hospital (0.40%), the medication was incorrect (1.20%), the doctor’s order was handled incorrectly (0.40%) and the nursing dispute incident was significantly lower (1.00% 3.60%) (P <0.05). The satisfaction rate of patients was 98.40%, while the satisfaction rate of 99% was higher than that before implementation (84.00%, 87%) (P <0.05). Conclusions The PDCA method can effectively improve the quality of emergency department care and handovers, improve the execution ability of nurses and reduce the occurrence of adverse events in patients. It is helpful to reduce the medical disputes and improve the patient satisfaction rates.