护士主导的持续改进在规范母婴同室新生儿血糖监测中的应用

目的:探讨护士主导的持续改进在规范母婴同室新生儿血糖监测中的实施及效果。方法:按照PDCA循环的方法共进行两个循环。第一循环:2018年1-5月调查对象为妊娠期糖尿病(GDM)孕妇娩出新生儿,调查后制定血糖监测管理规范和各项措施,比较实施措施前后该类新生儿血糖监测规范率。第二循环:2018年9-12月,根据第一循环制定出的制度,将调查对象扩大到母婴同室低血糖高风险新生儿,调查后制定措施,比较实施措施前后该类新生儿血糖监测规范率。结果:第一循环改进后母婴同室GDM孕妇娩出新生儿血糖监测规范率由2.04%提升到38.00%;第二循环改进后母婴同室低血糖高风险新生儿血糖监测规范率由29.17%提升到79.63%,GDM孕妇娩出新生儿血糖监测规范率由34.48%提升到80.65%(均P<0.01)。结论:PDCA循环有效规范了医院母婴同室新生儿血糖监测,进一步完善了医疗和护理管理体系。

Application of continuous improvement led by nurses in standardizing blood glucose monitoring of newborns in Mother-Newborn Wards

Objective: To explore the implementation and effect of continuous improvement led by nurses in standardizing the monitoring of neonatal blood glucose in Mother-Newborn Wards.Methods: According to the method of PDCA cycle,two cycles were carried out.The first cycle: from January to May 2018,the subjects were newborns delivered by pregnant women with gestational diabetes mellitus( GDM).After the investigation,the management norms and measures of blood glucose monitoring were formulated,and the standardized rate of blood glucose monitoring of such newborns was compared before and after the implementation of the measures.The second cycle: from September to December 2018,according to the system formulated in the first cycle,the survey objects were expanded to newborns with high risk of hypoglycemia in Mother-Newborn Wards.Measures were formulated after the investigation,and the standardized rate of blood glucose monitoring of such newborns was compared before and after the implementation of the measures.Results: After the improvement of the first circulation,the standard rate of blood glucose monitoring of newborns delivered by GDM pregnant women increased from 2.04% to 38.00%;after the improvement of the second circulation,the standard rate of blood glucose monitoring of high-risk newborns with hypoglycemia increased from 29.17% to 79.63%,and the standard rate of blood glucose monitoring of newborns delivered by GDM pregnant women increased from 34.48% to 80.65%( all P < 0.01).Conclusion: PDCA cycle effectively standardizes the blood glucose monitoring of newborns in Mother-Newborn Wards,and further improves the medical and nursing management system.