构思-设计-实现-运用模式在经皮内镜下腰椎手术集液方法持续改进中的应用研究

目的评价基于构思-设计-实现-运用(CDIO)模式的创新思维在经皮内镜下腰椎手术集液方法持续质量改进过程中的应用效果。方法2018年成立持续质量改进小组,对经皮内镜下腰椎手术灌注液集液效果差的原因进行分析,发挥小组成员基于CDIO模式的创新思维能力,对集液方法进行不断改进并定期反馈。结果持续质量不断改进后仅3例术者手术衣衣袖被溅湿,余均未见浸湿情况发生,较改进前手术单、术者手术衣、手术间地面浸湿发生率均明显降低(P<0.01);巡回护士用手术巾吸湿地面以及手术一助吸引排出液体的工作量较改进前均明显降低(P<0.01);手术医生和巡回护士的满意度均明显提高(P<0.01);成员创新思维能力提高(P<0.05)。结论应用CDIO模式在持续质量改进过程中能提高经皮内镜下腰椎手术中灌注液集液的有效性,明显减轻护理人员的工作量并降低手术间地面污染的发生率,同时提高小组成员的创新能力,从而促进手术护理质量的不断提升。

Application of innovative thinking based on conceive design implement operate mode in continuous improvement of fluid collection method in percutaneous endoscopic lumbar surgery

Objective To evaluate the application effect of conceive design implement operate based innovative thinking in the continuous quality improvement of percutaneous endoscopic lumbar surgery fluid collection method.Methods A continuous quality improvement group was set up to analyze the causes of poor collection effect of perfusion fluid in percutaneous endoscopic lumbar surgery,to give full play to the innovative thinking ability of team members based on CDIO mode,to continuously improve the collection method and give regular feedback.Results After the continuous improvement of quality,only 3 cases of the sleeve of the surgical gown were splashed,and the rest were not soaked.It's much lower than that of the operation sheet,the surgical gown and the floor of the operating room before the improvement(P<0.01).The workload of the touring nurses using the surgical towel to absorb the floor and the hand operation to help to attract and discharge the liquid was significantly lower than that before the improvement(P<0.01);The satisfaction of nurses,surgeons and touring doctors was significantly improved(P<0.01),and the innovative thinking ability of members was significantly improved(P<0.05).Conclusion In the process of continuous quality improvement,the application of innovative thinking based on CDIO mode can effectively improve the effectiveness of perfusion fluid collection in percutaneous endoscopic lumbar surgery,significantly reduce the workload of nursing staff and the incidence of ground pollution in the operating room,and improve the innovation ability of team members,so as to promote the continuous improvement of surgical nursing quality.