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护理研究

品管圈在持续提高血液透析患者血红蛋白达标率中的应用研究

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  • 1. 同济大学附属杨浦医院肾内科

收稿日期: 2017-12-05

  修回日期: 2018-01-23

  网络出版日期: 2018-04-12

基金资助

上海市卫生与计划委员会课题(201440341)

The research of continuous quality improvement method on standard–reaching rate of hemoglobin in maintenance hemodialysis patients

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Received date: 2017-12-05

  Revised date: 2018-01-23

  Online published: 2018-04-12

摘要

【摘要】目的观察品管圈的管理方法在提高维持性血液透析患者血红蛋白达标率中的应用效果。方法2014 年7 月~2015 年2 月选取杨浦医院维持性血液透析患者114 名,2015 年12 月~2016 年4 月再随机选取50 名血液透析患者,分2 阶段应用品管圈的管理方法推进提高维持性血液透析患者血红蛋白达标率的任务,逐步实施管理方法中主题选定、现况把握、真因验证、对策拟定及实施、效果检验(plan-docheck-action,PDCA)步骤,观察此管理方法对提高血液透析患者血红蛋白达标率的效果。结果通过真因验证,找出第一阶段血液透析患者达标率低的真因在于宣教不及时、治疗未个体化及抗凝操作不规范,在采取针对性措施后血红蛋白达标率从25%上升到53%,实施前后比较统计有显著性差异(χ2=16.65,P 值<0.001)。第二阶段达标率未能进一步提高的真因为药品遗漏及保存失当,定期随访的手续较繁琐,在统一保管药品及一站式检测对策实施后,达标率从45%提高到60%。结论品管圈是提高医疗质量是一种有效可行的管理方法,值得进一步推广应用。

本文引用格式

冯雪芳,蒋茜,曾洋,王畅,王雅楠,周蓉 . 品管圈在持续提高血液透析患者血红蛋白达标率中的应用研究[J]. 中国血液净化, 2018 , 17(04) : 265 -267 . DOI: 10.3969/j.issn.1671-4091.2018.04.014

Abstract

【Abstract】Objective To investigate the continuous quality improvement method on standard- reaching rate of hemoglobin in maintenance hemodialysis (MHD) patients. Method We set up a group of 50 MHD patients for this study and carried out the plan-do-check-action (PDCA) cycle twice to find out the causes of anemia in most patients at different stages and to observe the standard-reaching rate of hemoglobin after the performance of continuous quality improvement method. Result The standard-reaching rate of hemoglobin in these MHD patients improved gradually by a series of methods (P=0.00045). Conclusion The continuous quality improvement method is a valuable management worthwhile to be used clinically.
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