PDCA管理模式在急危重症患者急救流程中的应用

目的 探讨PDCA管理模式在急危重症患者急救流程中的应用效果.方法 由某三级甲等医院急诊科的12名主管护师组成PDCA管理小组,以2014年7~12月急诊接诊患者的护理程序为调查对象.此时间段内的患者按照常规的就诊流程就诊,PDCA管理小组成员对此时间段内相关的急诊、急救护理质量进行现状调查,找出目前存在的护理质量问题,针对问题进一步分析原因、制定计划、改进措施,实施方案、定时监控检查,持续质量改进.对经PDCA管理后的2015年4~9月急诊接诊患者的护理程序再次进行统计调查,比较改善前后对应的指标,包括急危重症患者的抢救时间和患者对护理的满意度.结果 将改善前与改善后急危重症患者的抢救时间进行比较分析,差异有统计学意义(P<0.05);将患者的满意度进行比较分析,差异有统计学意义(P<0.05);将2015年10~12月的相关指标与改善后进行比较分析,差异有统计学意义(P<0.05).说明巩固调查阶段的急诊急救质量优于改善后的急救质量,且在持续质量改进中.结论 PDCA管理模式的实施,可显著缩短急危重症患者的抢救时间,提高患者的护理满意度.PDCA管理模式可被用作护理管理层简单可靠的质控管理工具.

The effect of the application of PDCA management model in emergency treatment of emergency patients

Objective To study the effect of the application of PDCA management model in emergency treat-ment of emergency patients. Methods A group of 12 supervisors from the emergency department of a tertiary hospital were included in a PDCA management team. The nursing procedures of patients of the emergency department from July to December 2014 were taken as the objects of investigation. The patients in this period were referred to the regular pro-cedure. The members of PDCA management team investigated the quality of emergency and emergency care during the time period to find out the nursing quality problems, analyze the causes of the problem, make plans, improve meas-ures, implement the plan, check the monitoring regularly, and continuously improve the quality. The nursing proce-dures of patients receiving emergency treatment from April to September 2015 after the management of PDCA were fur-ther investigated. The corresponding indexes before and after the improvement were compared, including the rescue time of the critically ill patients and the patients'nursing satisfaction. Results The rescue time of acute and critically ill patients before and after the improvement was compared and the difference was statistically significant (P<0.05). The patients'satisfaction was compared and the difference was statistically significant (P<0.05). The relevant indexes from October to December 2015 and after the intervention were compared and analyzed, and the difference was statisti-cally significant(P<0.05), which indicated that the emergency first-aid quality in the consolidation investigation stage was superior to that of the improved first aid quality and the quality improvement lasted. Conclusions The implemen-tation of PDCA management mode can significantly shorten the rescue time of critically ill patients and improve the pa-tients'nursing satisfaction. PDCA management mode can be used as a simple and reliable quality control management tool for nursing management.