持续质量改进在围手术期护理质量管理中的应用

目的：采用持续质量改进方法解决围手术期护理过程中的不规范护理行为，提高围手术期护理质量。方法按照围手术期护理常规及护理质量检查标准，制定围手术期护理质量效果调查表，在持续质量改进前后对10个病区的术后康复患者进行围手术期护理效果调查，并对病区围手术期护理质量进行检查。结果通过持续质量改进，各病区围手术期护理质量均有提高，其中神经外科从（78．7＆#177;3．25）分提高至（96．3＆#177;1．29）分，心胸外科从（70．1＆#177;4．31）分提高至（98．2＆#177;1．09）分，与改进前比较差异均有统计学意义（ t值分别为19．86，18．87；P＜0．01）。持续质量改进前后围手术期护理存在问题下降，手术室护士术前未访视从25．4％下降至3．6％，术后腕带保存不当从10．6％下降至3．6％，与改进前比较差异均有统计学意义（χ2值分别为23．72，9．13；P＜0．01）。结论通过围手术期持续质量改进有效地提高了围手术期护理质量，有效减少术后并发症的发生，并提高了住院患者的满意度。

Application of continuous quality improvement in perioperative nursing quality management

Objective To improve perioperative nursing behaviors and nursing quality by continuous quality improvement .Methods Questionnaire on perioperative nursing quality was designed according to perioperative nursing routine and quality inspection , and was used to investigate perioperative nursing effect and quality on postoperative patients in 10 wards before and after continuous quality improvement .Results Through continuous quality improvement , perioperative nursing quality in all wards was improved .The score improved from （78.7 ＆#177;3.25）to （96.3 ＆#177;1.29）in Neurosurgery Department, from （70.1 ＆#177;4.31） to （98.2 ＆#177;1.09） in Cardiothoracic Department , and the differences were statistically significant （ t=19.86,18.87, respectively;P＆lt;0.01）.Problems of nursing also dropped after continuous quality improvement , the rate of no preoperative visits by nurses decreased from 25.4% to 3.6%, the rate of wrong reservation of postoperative wristbands decreased from 10.6% to 3.6%, and the differences were statistically significant （χ2 =23.72, 9.13, respectively;P＆lt;0.01）.Conclusions Continuous quality improvement can effectively enhance perioperative nursing quality, reduce postoperative complications and improve patients ’ satisfaction.