6S管理模式在老年糖尿病肾病血液透析患者中的应用价值

目的探讨6S管理模式在老年糖尿病肾病血液透析患者中的应用价值，以此改善患者的生活质量，提升护理人员素质，更好地提高患者的透析效果。方法选取本院2010年1月～2012年6月收治的老年糖尿病肾病血液透析的患者90例，按照数字随机的方法分为两组，每组45例。对照组采用常规的治疗及护理模式；观察组采用6S管理模式进行干预。观察两组患者透析后1年的存活率及肾功能情况、并发症发生率、患者管理质量评估评分情况及透析时的操作实施情况。结果经过6S管理模式干预后，观察组患者的1年内存活率达93．3％（42／45），显著高于对照组的71．1％（32／45），且肾功能改善显著优于对照组，差异有统计学意义（P〈0．05）。观察组患者在治疗及随访过程中的低血压、高血压、心力衰竭、感染等并发症发生情况低于对照组，差异有统计学意义（P〈0．05）；其心律失常、低蛋白血症、视网膜病变等并发症发生情况低于对照组，但经比较差异无统计学意义（P〉0．05）。实施管理模式后医生及护理人员操作流程评分及病例质量考核评分均高于实施前和对照组，差异有统计学意义（P〈0．05）。结论6S管理模式在老年糖尿病肾病透析患者的治疗中效果显著，值得临床进一步研究和推广。

Application of 6S management model nursing intervention on diabetic nephropathy hemodialysis

Objective To discuss the application of 6S management model nursing intervention on diabetic nephropa- thy hemodialysis in order to get a better way to improve the quality of patients. Methods A total of 90 patients with diabetic nephropathy hemodialysis from January 2010 to June 2012 in our hospital were to be studied. The method ac- cording to numbers randomly divided into two groups of 45 cases. Control group with conventional treatment and care model for treatment; observation group 6S management intervention. Dialysis patients were observed after one year sur- vival and renal function case, the complication rate, patient management and quality assessment score of dialysis oper- ation implementation. Results After 6S management intervention group were observed after 1 year survival rate of 93.3% （42/45）, significantly higher than the 71.1% （32/45）, and the improvement of renal function was significantly better than the control group, there was a statistically significant difference between two groups （P 〈 0.05）. Patients in the treatment and follow-up process of hypotension, hypertension, heart failure, infection complications were lower than the control group, the difference was statistically significant （P 〈 0.05）. Arrhythmia, cerebrovascular accident, hy- poalbuminemia, retinopathy complications were lower than the control group, but there was no significant difference by comparison （P 〉 0.05）. The study group also found that implementation of the management mode doctors and nurses operating procedures and case quality assessment rating scores were higher than prior to the implementation and the control group, the difference was statistically significant （P 〈 0.05）. Conclusion 6S management model in elderly pa- tients with diabetic nephropathy dialysis treatment effect is remarkable, and worthy of further research and extension.