品管圈在降低神经内科患者静脉留置针非计划性拔管率的运用(1)
摘要：目的 应用品管圈的管理方法和技巧降低神经内科外周静脉留置针非计划性拔管率方面的效果。方法 成立品管圈活动小组，确定"降低静脉留置针非计划性拔管率"为活动主题，制定查检表对神经内科静脉留置针非计划性拔管率原因进行现状调查，运用头脑风暴法分析非计划性拔管的原因并制作鱼骨图，运用柏拉图要因分析及真因验证，再次运用头脑风暴法并结合查阅文献制定对策，选取有效对策并实施与检讨。结果 品管圈活动后，影响外周静脉留置针非计划性拔管率的主要因素(静脉炎、药物渗出、导管堵塞)得到了明显改善，使外周静脉留置针非计划性拔管率由改善前的54.34%下降至改善后的23.26%。结论 开展品管圈活动有利于解决实际存在的问题，有效降低了外周静脉留置针非计划性拔管率，减少了反复穿刺给患者带来的痛苦，提高护理质量和患者对护士的满意度。
关键词：品管圈；外周静脉留置针；非计划性拔管率
Application of the Quality Control Circle in Reducing the Rate of Non Planned Extubation of Patients with Venous Indwelling Needle in the Department of Internal Medicine
, http://www.100md.com
LUO La-di，CHEN Yan，HUANG Li-kui，GUO Yue，LU Yu-wei
(Sun Yixian Memorial Hospital， Zhongshan University，Guangzhou 510120，Guangdong，China)
Abstract：Objective To understand the effect of the management method and technique of the application of the quality control circle in reducing the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology. Methods We set up the quality control circle with the topic "To reduce the rate of unplanned extubation of the Indwelling needle in the peripheral vein"， making the investigation of the current situation of the cause of the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology by developing checklists. Then， the data was analysed and a fishbone diagram was developed by brainstorming method. After that， we used Pareto Cause Analysis， Root Cause Identification and information from literature to get the best solution. Results With the application of the quality control circle， the number of the main cause such as phlebitis， drug leakage and catheter blockage to the rate of unplanned extubation of the indwelling needle in the peripheral vein dropped and the rate decreased from 54.34% to 23.26%. Conclusion Applying the quality control circle is good for solving actual problem. It helped decrease the rate of unplanned extubation of the Indwelling needle in the peripheral vein， which not only can reduce the pain caused by repeated puncture but also improve the nursing quality and patients' satisfaction with nurses.
, 百拇医药
Key words：Quality control circle； Indwelling needle in the peripheral vein； Rate of unplanned extubation
品管圈(quality control circle，QCC)就是由相同、相近或互补性质工作场所的人们自动自发组成数人一圈的活动团队，通过全体合作，集思广益，按照一定的活动程序，活用科学统计工具集品管手法来解决工作中现存的问题[1]。在神经内科患者的治疗过程中，静脉滴注高渗脱水剂、高渗营养液、血管活性剂药物等是重要的治疗方法，然而此类药物刺激性大、频率高、渗透压高对静脉造成了不同程度的损伤，轻者可出现疼痛、静脉炎，严重的则造成局部的坏死等[2]。由于外周静脉留置针可以有效保护血管，减少了反复穿刺带来的痛苦，我科开展了品管圈在降低住院患者静脉留置针非计划性拔管率的活动，取得了良好效果，现将具体做法与体会报道如下。, http://www.100md.com(罗拉娣 陈燕 黄丽葵 等)
关键词：品管圈；外周静脉留置针；非计划性拔管率
Application of the Quality Control Circle in Reducing the Rate of Non Planned Extubation of Patients with Venous Indwelling Needle in the Department of Internal Medicine
, http://www.100md.com
LUO La-di，CHEN Yan，HUANG Li-kui，GUO Yue，LU Yu-wei
(Sun Yixian Memorial Hospital， Zhongshan University，Guangzhou 510120，Guangdong，China)
Abstract：Objective To understand the effect of the management method and technique of the application of the quality control circle in reducing the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology. Methods We set up the quality control circle with the topic "To reduce the rate of unplanned extubation of the Indwelling needle in the peripheral vein"， making the investigation of the current situation of the cause of the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology by developing checklists. Then， the data was analysed and a fishbone diagram was developed by brainstorming method. After that， we used Pareto Cause Analysis， Root Cause Identification and information from literature to get the best solution. Results With the application of the quality control circle， the number of the main cause such as phlebitis， drug leakage and catheter blockage to the rate of unplanned extubation of the indwelling needle in the peripheral vein dropped and the rate decreased from 54.34% to 23.26%. Conclusion Applying the quality control circle is good for solving actual problem. It helped decrease the rate of unplanned extubation of the Indwelling needle in the peripheral vein， which not only can reduce the pain caused by repeated puncture but also improve the nursing quality and patients' satisfaction with nurses.
, 百拇医药
Key words：Quality control circle； Indwelling needle in the peripheral vein； Rate of unplanned extubation
品管圈(quality control circle，QCC)就是由相同、相近或互补性质工作场所的人们自动自发组成数人一圈的活动团队，通过全体合作，集思广益，按照一定的活动程序，活用科学统计工具集品管手法来解决工作中现存的问题[1]。在神经内科患者的治疗过程中，静脉滴注高渗脱水剂、高渗营养液、血管活性剂药物等是重要的治疗方法，然而此类药物刺激性大、频率高、渗透压高对静脉造成了不同程度的损伤，轻者可出现疼痛、静脉炎，严重的则造成局部的坏死等[2]。由于外周静脉留置针可以有效保护血管，减少了反复穿刺带来的痛苦，我科开展了品管圈在降低住院患者静脉留置针非计划性拔管率的活动，取得了良好效果，现将具体做法与体会报道如下。, http://www.100md.com(罗拉娣 陈燕 黄丽葵 等)