品管圈活动降低护士对深静脉血栓风险评估的差异率分析(1)
摘要：目的 探讨品管圈活动降低护士对深静脉血栓评估的差异率，从而提升护士评分意识，提高护理安全。方法 2017年3月我院成立品管圈，通过品管圈步骤，于2017年3～8月对全院护士进行培训，以实地查看及访谈的形式，包括护士对Autar评分的理解，及给出一个固定病例，让不同层级护士对此进行评分，最后分析对比。结果 通过品管圈的开展，使团队各个方面的能力都得到了锻炼和提升。目标达成率为129.76%，进步率为79.88%，各层级护士对Autar评分表理解有差异由46.31%下降至23.12%，差异有统计学意义(P<0.05)。结论 通过此次品管圈活动，规范了护理人员Autar风险评估量表使用，增加了护士工作中的主观能动性，提高工作效率。
关键词：品管圈;深静脉血栓;风险评估;差异率
中图分类号：R473.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.057
, http://www.100md.com
文章编号：1006-1959(2019)07-0177-04
Abstract：Objective To explore the effect of quality control circle on the difference of nurses' evaluation of deep vein thrombosis， so as to improve the awareness of nurses' scores and improve the safety of nursing. Methods In March 2017， our hospital set up a quality control circle to train nurses in the hospital from March to August 2017 through the quality control circle. In the form of field observations and interviews， including nurses' understanding of Autar scores， and A fixed case is given to allow different levels of nurses to score this and finally analyze and compare. Results Through the development of the quality control circle， the ability of all aspects of the team has been improved and improved. The target achievement rate was 129.76%， and the improvement rate was 79.88%. The difference in the understanding of the Autar scores by nurses at all levels decreased from 46.31% to 23.12%，the difference was statistically significant (P<0.05). Conclusion Through the quality control circle activities， the use of the Autar risk assessment scale for nursing staff has been standardized， which has increased the subjective initiative of nurses and improved work efficiency.
, 百拇医药
Key words：Quality control circle;Deep vein thrombosis;Risk assessment;Difference rate
深靜脉血栓形成(deep vein thrombosis，DVT)是外科手术后早期的并发症之一。有研究显示[1]，骨科、普外科术后DVT的发生率为10%～63%。且近年来，DVT形成有逐渐增加的趋势，血栓的形成严重影响患者的术后康复，增加患者经济负担和心理压力，严重者可危及患者生命[2，3]。DVT评估是指判断患者发生 DVT的风险级别并据此采取适当的预防措施的过程[4]。因此，正确评估DVT，对住院患者积极采取防范措施，是防范住院患者DVT发生的重要途径。本文通过品管圈(quality control circles，QCC)活动，降低护士对深静脉血栓评估的差异率，让护理人员运用Autar风险评估量表，提升护士的评分意识，提高护理安全。
1资料与方法
1.1一般资料 南京市中医院是一所集医、教、研等功能于一体的三级甲等综合性中医医院。医院临床护理单元24个，由护理部统一管理，实行的是分管院长领导下的三级垂直管理体制。医院根据江苏省实施医院护士岗位管理的指导意见，以及《卫生部关于实施医院护士岗位管理的指导意见》的精神，结合医院实际情况，将护理人员的临床能级分为四个层级，每一层级均赋予不同的工作职责和能力要求(N1：基本级，N2：胜任级，N3：骨干级，N4：专家级)。此次品管圈活动针对院内各层级护士对深静脉血栓风险评估的理解程度进行分析，各科室随机调查N1、N2、N3三个层级护士各1名，共18个科室参与调查，共计54人。其中54人均为女性，年龄22～40岁，平均年龄(32.56±2.53)岁;学历：大专占18.52%，本科占22.22%。, http://www.100md.com(耿华)
关键词：品管圈;深静脉血栓;风险评估;差异率
中图分类号：R473.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.057
, http://www.100md.com
文章编号：1006-1959(2019)07-0177-04
Abstract：Objective To explore the effect of quality control circle on the difference of nurses' evaluation of deep vein thrombosis， so as to improve the awareness of nurses' scores and improve the safety of nursing. Methods In March 2017， our hospital set up a quality control circle to train nurses in the hospital from March to August 2017 through the quality control circle. In the form of field observations and interviews， including nurses' understanding of Autar scores， and A fixed case is given to allow different levels of nurses to score this and finally analyze and compare. Results Through the development of the quality control circle， the ability of all aspects of the team has been improved and improved. The target achievement rate was 129.76%， and the improvement rate was 79.88%. The difference in the understanding of the Autar scores by nurses at all levels decreased from 46.31% to 23.12%，the difference was statistically significant (P<0.05). Conclusion Through the quality control circle activities， the use of the Autar risk assessment scale for nursing staff has been standardized， which has increased the subjective initiative of nurses and improved work efficiency.
, 百拇医药
Key words：Quality control circle;Deep vein thrombosis;Risk assessment;Difference rate
深靜脉血栓形成(deep vein thrombosis，DVT)是外科手术后早期的并发症之一。有研究显示[1]，骨科、普外科术后DVT的发生率为10%～63%。且近年来，DVT形成有逐渐增加的趋势，血栓的形成严重影响患者的术后康复，增加患者经济负担和心理压力，严重者可危及患者生命[2，3]。DVT评估是指判断患者发生 DVT的风险级别并据此采取适当的预防措施的过程[4]。因此，正确评估DVT，对住院患者积极采取防范措施，是防范住院患者DVT发生的重要途径。本文通过品管圈(quality control circles，QCC)活动，降低护士对深静脉血栓评估的差异率，让护理人员运用Autar风险评估量表，提升护士的评分意识，提高护理安全。
1资料与方法
1.1一般资料 南京市中医院是一所集医、教、研等功能于一体的三级甲等综合性中医医院。医院临床护理单元24个，由护理部统一管理，实行的是分管院长领导下的三级垂直管理体制。医院根据江苏省实施医院护士岗位管理的指导意见，以及《卫生部关于实施医院护士岗位管理的指导意见》的精神，结合医院实际情况，将护理人员的临床能级分为四个层级，每一层级均赋予不同的工作职责和能力要求(N1：基本级，N2：胜任级，N3：骨干级，N4：专家级)。此次品管圈活动针对院内各层级护士对深静脉血栓风险评估的理解程度进行分析，各科室随机调查N1、N2、N3三个层级护士各1名，共18个科室参与调查，共计54人。其中54人均为女性，年龄22～40岁，平均年龄(32.56±2.53)岁;学历：大专占18.52%，本科占22.22%。, http://www.100md.com(耿华)