品管圈实践在高龄卧床患者PICC规范维护率中的应用

目的：探讨品管圈实践在高龄卧床患者外周静脉置入中心静脉导管(peripherally inserted central catheter，PICC)规范维护率中的应用。方法：选取我院2014年10月至2015年4月行PICC置管的高龄卧床患者50例，为品管圈(quality control circle，QCC)活动前的对照组。另选取2015年5月至2015年10月行PICC置管的高龄卧床患者50例，为QCC活动后的观察组。通过品管圈活动的实践，观察比较实施前后PICC规范维护率的变化。结果：有形成果：QCC活动实践后，PICC不规范维护率降为5.3%(16/300)，明显低于QCC活动前，差异具有统计学意义(χ2=46.217，P<0.05)。即PICC规范维护率为94.7%，超过目标值92%。无形成果：本次QCC活动对各位圈员的综合能力也有一定的提升，主要包括QCC手法运用能力、团队协作能力、逻辑思维能力、护理品质意识、自信心、责任心等方面的提升，与活动前比较，差异均具有统计学意义(P<0.05)。结论：品管圈实践可显著提高高龄卧床患者的PICC规范维护率，并能有效提升圈员的综合能力。

The application of quality control circle practice in elderly bedridden patients to maintain specification rates of peripherally inserted central catheter

Objective: To investigate the application of quality control circle (QCC) practice in elderly ambulatory patients with speciifcation maintenance rate of PICC.Methods: 50 elderly ambulatory patients with PICC in our hospital from October 2014 to April 2015 were chosen as control group before QCC activities; another 50 elderly ambulatory patients with PICC from May 2015 to October 2015 were chosen as observation group atfer QCC activities. The changes of specification maintenance rate was observed and compared before and after practice QCC activity.Results:Tangible outcomes: after QCC activities practice, the non-standard maintenance rate of PICC dropped to 5.3% (16/300), signiifcantly lower than that before the QCC activities, the difference was statistically significant (χ2=46.217,P<0.05). Namely the specification maintenance rate of PICC was 94.7%, exceeding the target of 92%. Invisible result: the QCC activities also improved the comprehensive ability of members, which including the QCC techniques in the skills, teamwork skills, logical thinking ability, care quality awareness, self-confidence, responsibility, etc., compared with before activities, the difference was statistically signiifcant (P<0.05).Conclusion:QCC practices can signiifcantly improve the speciifcation maintenance rate of PICC in elderly ambulatory patients and can effectively improve the comprehensive capacity of ring members.