质控前移在静脉留置针质量管理中的应用

目的：探讨质控前移临床的前瞻性质量管理模式在静脉留置针应用及维护质量管理中的作用。方法选择某院实施责任制整体护理模式的12个住院病区，建立三级护理质控管理体系，由责任护士责任组长护士长组成三级质控网络，在静疗小组专业指导下进行静脉留置针应用及维护质量持续改进（ QC）。比较QC活动前后输液工具应用情况和留置针维护情况。结果 QC活动后钢针的使用率由53．6％下降至31．3％，差异有统计学意义（χ2＝45．099，P＜0．01）；留置针维护中胶布缠绕过多、敷贴卷边、穿刺点遮挡等不良现象发生率下降，差异有统计学意义（P＜0．01）。结论质控前移临床，各级人员分别承担相应的责任，提高了临床护士质量管理的参与意识，缩短了质控管理半径，并以临床实际问题为导向，从而提高了质控效率，留置针使用率及维护质量得到明显提高。

Application of prospective quality management in quality control of indwelling needle

Objective To discuss the application of prospective quality management in quality control of indwelling needle .Methods Twelve wards carried out the nurse grading management and set up prospective quality control management system , which was charged by a three-grading system of responsible nurse-responsible nursing group leader-head nurse .The intravenous indwelling needle was intervened under the consult of the professional guidance .The usage and maintenance of the indwelling needle before and after applying the prospective quality control management system were compared .Results The usage of the indwelling needle was decreased from 53.6%to 31.3%.The difference was significant （χ2 =45.099,P〈0.01）.The incidence of bad conditions of the maintenance was significantly decreased （P〈0.01）.Conclusions Every level of nursing staff is responsible for the prospective quality control management system , which can improve the participation of quality control and shorten the management extent .The system is oriented from clinical practical problems , so as to improve the control efficiency , and the usage and maintenance quality has been improved obviously .