根本原因分析法在提高骨科患者功能锻炼依从性中的研究

目的：探讨根本原因分析法在提高骨科患者功能锻炼依从性中的运用及效果。方法成立根本原因分析法小组( Root Cause Analysis, RCA),自行设计《骨科患者功能锻炼依从性的影响因素》和《骨科患者功能锻炼依从性》调查问卷,采用头脑风暴法和鱼骨图从人员、材料、方法、环境四个方面找出原因并分析出根本原因,针对根本原因制定相应护理措施并实施,评价RCA实施前后骨科患者功能锻炼依从性(率)及影响因素影响频次。结果 RCA实施后,骨科患者功能锻炼影响因素影响频次均较RCA实施前下降( P<0.05),在功能锻炼频次、方法、种类、时间、幅度及主动性6个方面患者依从性(率)较RCA实施前有所提高( P<0.05)。功能锻炼依从性(率)从干预前的44.32%提高到干预后的83.02%。结论应用根本原因分析法可提高骨科患者功能锻炼依从性,是一种有效的管理方法。

The study of Root Cause Analysis on improving the functional exercises' compliance of orthopedic patients

Objective To explore the application effect of Root Cause Analysis on improving the functional ex-ercises' compliance of orthopedic patients. Methods A RCA team was set up and two self-designed questionnaires in terms of the functional exercises' compliance and its influencing factors were adopted. The brainstorming and fishbone diagram were used to explore the reasons and analyze the root cause from the aspects of the personnal, materials, meth-od and environment. The corresponding nursing measures were formulated and implemented according to the root cau-ses. Then the functional exercises' compliance and the influencing factors and influencing frequency of orthopedic pa-tients before and after the implementation of RCA were evaluated. Results The functional exercises' influencing factors and influencing frequency of orthopedic patients after the implementation of RCA was significantly lower than before ( P<0. 05). The compliance in terms of the frequency, methods, kinds, time, range and the initiative of functional exer-cise after the implementation of RCA were better than before ( P<0. 05 ) . The rate of exercise compliance were in-creased from 44. 32% before RCA to 83. 02% after RCA. Conclusions The application of Root Cause Analysis can im-prove the exercise compliance of orthopedic patients, it's an effective management tool.