PDCA循环在护理管理不合格静脉血标本中的应用

目的探讨PDCA循环在护理管理不合格静脉血标本中的应用效果。 方法采用PDCA循环对不合格静脉血标本进行管理，应用信息化软件对比湖北天门市第一人民医院2020年1月至9月（改善前）与2021年1月至9月（改善后）住院患者不合格静脉血标本的变化情况，以持续性改进标本质量。 结果2020年1月至9月的住院患者检验标本750 349例，不合格率为21.03/万（1578/750 349），2021年1月至9月应用PDCA循环管理后，住院患者检验标本不合格率降为17.78/万（1903/1 070 498），改善前后，标本总不合格率、抗凝标本凝集率、血培养污染率、患者识别错误率、标本运输途中损坏率、标本采集时机不正确率比较差异均具有统计学意义（χ²=24.4732，322.9718，22.0901，14.9955，8.4113，302.7255；P均＜0.05），且整改后重症监护室（ICU）、新生儿病区、儿科病区、感染科四个不合格率较高的科室静脉血标本总不合格率呈逐步下降趋势。 结论在护理管理中，PDCA循环工具管理后有效降低了住院患者静脉血标本的不合格率，提升了护理管理质量，保证了检验前质量，提高了检验结果的准确性，大大减少了医疗资源的浪费，提升了医院的运营效率，值得推广和应用。

Application of PDCA circulation in nursing management of unqualified venous blood specimen

ObjectiveTo explore the application effect of PDCA circulation in nursing management of venous blood specimens. MethodsThe information software was used to compare the changes of unqualified venous blood samples from inpatients in our hospital from January to August 2020 (before improvement) and from January to August 2021 (after improvement), and PDCA cycle management was used to manage unqualified venous blood samples, so as to continuously improve specimen quality. ResultsFrom January to September in 2020, 750 349 inpatients were examined, and the unqualified rate was 21.03/10 000 (1578/750 349). After the application of information software combined with PDCA cycle management from January to September in 2021, the unqualified rate was reduced to 17.78/10 000 (1903/1 070 498). Comparison before and after improvement, there were statistically significant differences in total sample rejection rate, anticoagulant sample agglutination rate, blood culture contamination rate, patient identification error rate, sample damage rate during transportation, and sample collection timing error rate (χ² = 24.4732, 322.9718, 22.0901, 14.9955, 8.4113, 302.7255; P＜0.05). And the unqualified rate of venous blood samples in ICU, neonatology department, pediatric department and infection department showed a trend of gradual decline after rectification. ConclusionThe application of information software combined with PDCA cycle management can effectively reduce the unqualified rate of venous blood samples of inpatients in our hospital, improve the quality of nursing management and ensure the quality before inspection, greatly reduce the waste of medical resources, and improve the operation efficiency of the hospital, so it is worth popularizing and applying.