品管圈活动对提高动静脉内瘘一次性穿刺成功率的效果观察

目的探讨品管圈活动（QCC）对提高动静脉内瘘一次性穿刺成功率的效果。方法成立Qcc小组，选定“提高动静脉内瘘一次性穿刺成功率”为活动主题，2012年4～12月对240例需维持性血液透析终末期肾病患者采用Qcc的穿刺方式，分析影响动静脉内瘘穿刺成功率的原因，制订相应的整改措施并组织实施，比较实施QCC前、后患者一次性穿刺成功率、血管通路血流量达标率及内瘘穿刺失败并发症发生率。结果实施Qcc前、后患者一次性穿刺成功率、血管通路血流量达标率及内瘘穿刺失败并发症的发生率比较，差异均有统计学意义（P〈0．05）；各圈员在沟通与协调、积极性、责任心、荣誉感、团队合作、和谐程度、面对问题的勇气、质量改善手法的认识、个人素质修养方面均有一定程度的提高。结论QCC在提高维持性血液透析患者动静脉内瘘一次性穿刺成功率方面取得较好效果．值得推广应用。

Clinical observation of QCC in improving the success rate of arteriovenous fistula disposable puncture

Objective To explore the application and effectiveness of quality control eircle（QCC） program in improving the success rate of arteriovenous fistula disposable puncture. Methods QCC activity group was established to choose the theme of improving the success rate of arteriovenous fistula disposable puncture. The disposable puncture based on Qcc was applied in 240 end-stage renal disease patients with maintenance haemodialysis in the hospital from April to December 2012 to analyze the reasons for the success of the disposable puncture, enact the corresponding measure and compare the success rate of disposable puncture, target rate of blood volume in vascular access and the occurrence rate complications because of the failure of fistula dis- posable puncture before and after the implementation of QCC. Results The comparison on success rate of disposable puncture, target rate of blood volume in vascular access and occurrence rate of complications because of the failure of fistula disposable puncture before and after QCC in patients had statistically significant difference （P〈0.05）,while it had certain improvement for the circle members on communication and coordination, enthusiasm, responsibility, sense of honor,collaboration ,harmonious de- gree, courage to the problems, cognition of quality improvement and personal accomplishment. Conclusion QCC program has a good effectiveness in improving the success rate of arteriovenous fistula disposable puncture for patients with maintenance haemodialysis, and it is worthy of popularization.