【摘要】目的探讨Ⅰ级质量控制在三甲医院大型血液净化中心同质化管理中的应用效果。方法于2018 年4 月建立血液净化中心Ⅰ级质量控制管理网络，全体护士参与质量控制，对存在问题及时反馈整改。比较Ⅰ级质量控制管理前与Ⅰ级质量控制管理后(2018 年3 月～2019 年4 月)1 年患者满意度，获取血液透析上岗证少于3 年和大于3 年护士的理论操作平均分，并作前后和组间比较。结果Ⅰ级质量控制管理后患者满意度上升(χ2=5.065，P =0.024)，获得血液透析上岗证少于3 年和大于3 年的护士理论操作平均分在Ⅰ级质量控制开展1 年后都得到改善(t 值分别为4.271,2.430；P 值分别为0.002，0.025)；Ⅰ级质量控制管理前组别之间成绩平均分有差异(t=5.347，P =0.001)，开展质量控制1 年后无差异(t=0.547，P=0.589)。结论Ⅰ级质量控制在血液净化中心同质化管理中的应用提升了护士理论和操作水平，低年资护士进步尤其显著，最终不仅增加了患者满意度，更使患者在同质化规范性的护理服务中获益。

【Abstract】Objective To investigate the application effect of grade I quality control in the homogeneous management of large blood purification centers in tertiary hospitals. Methods A grade I quality control management network of the blood purification center was established in April 2018, and all nurses participated in quality control and feedback in time for renovation. Satisfaction from patients in one year (March 2018 to April 2019) was compared before and after grade I quality control management. The average knowledge and operation scores were compared between groups before and after grade I quality control management
in certificated hemodialysis nurses working less than 3 years and those working more than 3 years. Results Satisfaction from patients increased significantly after grade Ⅰ quality control management (χ2=5.065, P=0.024). The average knowledge and operation scores improved significantly after one year of grade I quality control management in the two groups of nurses (t=4.271 and 2.430, P=0.002 and 0.025). The average scores were different between the two groups before grade I quality control management (t=5.347, P=0.001) and became no differences after grade I quality control management for one year (t=0.547,
P= 0.589). Conclusion The application of grade I quality control in homogeneous management of blood purification centers improved the knowledge and operation levels of nurses, especially nurses with less experiences. Eventually, satisfaction from patients increased and patients benefited from homogeneous and standardized nursing services.