品管圈在降低神经内科患者静脉留置针非计划性拔管率的运用.docVIP

品管圈在降低神经内科患者静脉留置针非计划性拔管率的运用 　　摘要：目的 应用品管圈的管理方法和技巧降低神经内科外周静脉留置针非计划性拔管率方面的效果。方法 成立品管圈活动小组，确定降低静脉留置针非计划性拔管率为活动主题，制定查检表对神经内科静脉留置针非计划性拔管率原因进行现状调查，运用头脑风暴法分析非计划性拔管的原因并制作鱼骨图，运用柏拉图要因分析及真因验证，再次运用头脑风暴法并结合查阅文献制定对策，选取有效对策并实施与检讨。结果 品管圈活动后，影响外周静脉留置针非计划性拔管率的主要因素（静脉炎、药物渗出、导管堵塞）得到了明显改善，使外周静脉留置针非计划性拔管率由改善前的54.34%下降至改善后的23.26%。结论 开展品管圈活动有利于解决实际存在的问题，有效降低了外周静脉留置针非计划性拔管率，减少了反复穿刺给患者带来的痛苦，提高护理质量和患者对护士的满意度。 　　关键词：品管圈；外周静脉留置针；非计划性拔管率 　　Application of the Quality Control Circle in Reducing the Rate of Non Planned Extubation of Patients with Venous Indwelling Needle in the Department of Internal Medicine 　　LUO La-di，CHEN Yan，HUANG Li-kui，GUO Yue，LU Yu-wei 　　（Sun Yixian Memorial Hospital， Zhongshan University，Guangzhou 510120，Guangdong，China） 　　Abstract：Objective To understand the effect of the management method and technique of the application of the quality control circle in reducing the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology. Methods We set up the quality control circle with the topic To reduce the rate of unplanned extubation of the Indwelling needle in the peripheral vein， making the investigation of the current situation of the cause of the rate of unplanned extubation of the Indwelling needle in the peripheral vein in the Department of Neurology by developing checklists. Then， the data was analysed and a fishbone diagram was developed by brainstorming method. After that， we used Pareto Cause Analysis， Root Cause Identification and information from literature to get the best solution. Results With the application of the quality control circle， the number of the main cause such as phlebitis， drug leakage and catheter blockage to the rate of unplanned extubation of the indwelling needle in the peripheral vein dropped and the rate decreased from 54.34% to 23.26%. Conclusion Applying the quality control circle is good for solving actual problem. It helped decrease the rate of unplanned extubation of the Indwelling