品管圈管理预防脑血管病患者胃管意外滑脱的效果

目的：探讨品管圈管理在预防脑血管病患者胃管滑脱中的作用。方法成立品管圈，应用头脑风暴法确立预防胃管滑脱为活动的主题，拟定计划，分析现状，统计绘制柏拉图及鱼骨图分析原因，针对3项主要原因设定目标，制定对策，将实施对策进行效果确认、标准化，修改并制定科室的胃管管理制度。结果实施措施后我科脑血管留置胃管患者拔管率由27．5％（55／200）降低至5．0％（10／200），差异有统计学意义（χ^2＝27．05，P＜0．01）；设定的目标值均已达到，目标达成率115％，进步率81％。圈员责任心、自信心、积极性、解决问题的能力、团队凝聚力等方面的能力得到提升。结论品管圈管理研究了影响胃管滑脱的主要因素，制定了切实有效的预防措施，有效解决了胃管滑脱的问题，提高了护士的综合素质，提高了临床护理质量。

Application of quality control circle management in the prevention of accidental prolapse of gastric tube in patients with cerebral-vascular disease

Objective To investigate the effect of quality circle control （ QCC ） management in the prevention of accidental prolapse of gastric tube in patients with cerebral -vascular disease .Methods First, we set up the quality control circle , identified the theme , analyzed the current situation and drew the Pareto diagram and fishbone diagram to find out the three main causes .Then we set up the goals and developed strategies .At last we confirmed and standardized the results , modified and formulated the tube management system . Results After applying the QCC management , the extubation rate significantly reduced from 27.5%（55/200） to 5.0%（10/200） （χ^2 =27.05,P〈0.01）, with an achievement rate of 115%and progress rate of 81%.The responsibility, self-confidence, initiative, problem solving ability, team cohesion, communicate and coordinated ability, happiness and quality control means had improved after the application of QCC management . Conclusions The application of QCC management can effectively solve the accidental prolapse of gastric tube in patients with cerebral-vascular disease and improve the nursing quality and the comprehensive quality , and increase the cohesion of the department .