以问题为中心的质量改进模式在股骨颈骨折患者护理中的应用

目的：探讨以问题为中心的质量改进护理模式在股骨颈骨折患者中的应用效果。方法选择2011年11月-2013年2月78例股骨颈骨折患者为对照组行常规护理，选择2013年3-9月住院的86例股骨颈骨折患者为观察组，针对影响治疗效果的原因，成立以问题为中心的质量改进护理小组，构建股骨颈骨折患者术后管理模型。比较两组患者术后髋关节功能及并发症情况。结果观察组髋关节功能优良率为86．05％，对照组为71．80％，两组比较差异有统计学意义（χ2＝4．106， P＜0．05）；观察组患者下肢深静脉血栓、压疮、肺部感染、泌尿系统感染及便秘的发生率分别为4．65％，5．81％，3.49％，1.16％，2．33％，均低于对照组（10．26％，17．95％，11．54％，21．79％，12．82％），差异均有统计学意义（χ2值分别为3．722，5．217，4．831，7．205，4．902；P＜0．05）。结论采用以问题为中心的质量改进模式，可改善患者的髋关节功能，降低并发症，值得在临床广泛推广和应用。

Application of problem-based center quality improvement management model in nursing of patients with femoral neck fractures

Objective To investigate the effect of problem-based center quality improvement management model on nursing of patients with femoral neck fractures .Methods From February 2011 to November 2013 , 78 cases of femoral neck fracture patients received routine nursing as control group .Problem-based center quality improvement management team was set up , and the nursing management model of patients with femoral neck fractures was structured , then, 86 patients with femoral neck fractures from March to September in 2013 as observation group received the improved nursing .Results After the study , hip function excellent rates in observation group was higher than that in control group , and the difference was statistically significant （86.05%vs 71.80%;χ2 =4.106,P 〈0.05）.The incidence rates of deep venous thrombosis , pressure sores, pulmonary infection, urinary tract infection and constipation in observation group were 4.65%, 5.81%,3.49%,1.16%,2.33%,respectively,while that in control group were 10.26%,17.95%,11.54%, 21.79%,12.82%, and the differences were statistically significant （χ2 =3.722,5.217,4.831,7.205,4.902, respectively;P〈0.05）.Conclusions The model of problem-based center quality improvement management can significantly improve the patients＆#39;hip function, reduce complications , which is worthy of wider promotion and application .