品管圈对降低胃肠外科患者失禁性皮炎发生率的影响

目的 探讨品管圈手法在降低胃肠外科患者失禁性皮炎(incontinence associated dermatitis，IAD)发生率的应用效果，减少患者痛苦及住院时间，提高患者满意度。 方法 蚌埠医学院第一附属医院胃肠外科从2014年1—10月成立失禁性皮炎品管圈小组，确定以“降低胃肠外科患者失禁性皮炎发生率”为活动主题，通过制定查检表，1～3个月查检患者120例应用脑力激荡方法查检影响失禁性皮炎发生的因素，应用鱼骨图、柏拉图、柱状图等分析患者、家属、医护人员等因素对失禁性皮炎的影响，学习相关理论进行皮肤评估，改进护理工具，对护理流程进行培训，要因进行汇总，制定真因查检表查检真因后确定对策实施与检讨，最后制定标准化流程在全院进行推广。 结果 本小组解决了在实施过程中遇到的压疮高危，更换尿垫不及时，局部皮肤潮湿，护理评估不准确、不及时的问题的应用现状。 结论 品管圈活动在提高个人素质修养、解决问题的能力、个人责任心、积极性、自信心、团队凝聚力及与患者的沟通协调能力等方面都有所提升，使护理质量得到持续改进，其发展趋势是广泛应用品管圈这个平台来完善护理措施、细化工作流程、提高优质护理服务质量。 

Role of quality control circles in reducing the incidence of incontinent dermatitis in patients with gastrointestinal surgery

Objective To investigate the value of the quality of control circle technique in reducing the incidence of incontinent dermatitis,to release the pain of patients,shorten the hospital delay,and improve patients satisfaction. Methods The quality circle group for preventing incontinence dermatitis was established in our hospital between January,2014 and October,2014.The theme "reduce the incidence of incontinence dermatitis in patients with gastrointestinal surgery" was determined.The self-made check sheet was used to investigate 120 patients during 3 months,and the brainstorming method was performed to assess the influencing factors of incontinence dermatitis.The fishbone diagram,Plato and histogram were used to evaluate the effect of patients,families and medical staff on the incidence of incontinence dermatitis.Meanwhile,QC group learned skin assessment related theory,improved nursing tool,trained the nursing process,summarized the essential factors,made true cause check sheet,determined the strategy,and developed standardized processes for promoting in whole hospital. Results The high risk of pressure sores,delayed replacement of diaper,local skin moist,inaccurate and delayed nursing assessment that met in nursing process was solved. Conclusion The quality management circle activity is helpful in improving the personal quality,responsibility,enthusiasm and self-confidence,group cohesiveness,problem solving skills,doctor-patient communication,and make continual improvement of nursing quality.