【摘要】 目的探讨品管圈活动在降低血液透析患者早期内瘘启用期穿刺失败率中的应用效果。方法选取15例患者138次穿刺为对照组,统计穿刺失败率查找原因,以"降低血液透析患者早期内瘘启用期穿刺失败率"为改善主题,制定对策形成标准化的改善措施。选取15例患者128次穿刺为试验组,进行了10月的品管活动,比较两组护理效果。结果实施品管圈后血液透析患者早期内瘘启用期穿刺失败率由活动前的17.39%降至4.69%,内瘘知识掌握率52.90%升至91.41%、内瘘评估合格率86.23%升至96.88%,患者对护士穿刺技术满意度由83.33%提高到98.44%,前后比较差异有统计学意义(P<0.05);年节约患者医疗费40682.40元,圈员能力得到明显提升。结论通过品管圈活动开展,有效降低了血液透析患者早期内瘘启用期穿刺失败率,节约了患者医疗费,创新了穿刺与宣教方法以及血透患者居家内瘘锻炼监管模式,提高了患者满意度。更多还原

【Abstract】 Objective To explore the application effect of quality control circle activity in reducing failure rate of puncture during initial using period in early stage of internal fistula among patients with hemodialysis.Methods To select patients of 15 examples who underwent 138 times of punctures as the control group,and the reasons for the failure rate of puncture were counted. Taking"reducing failure rate of puncture during early stage of internal fistula in hemodialysis patients"as the theme of improvement,countermeasures were formulated to form standard improvement measures. Patients of 15 examples who underwent 128 times of punctures were selected as the experimental group. Quality circle control activities were performed in October among patients in the experimental group. The effect of nursing was compared between the two groups. Results After the implementation of quality circle control,the failure rate of puncture in the early stage of internal fistula in hemodialysis patients decreased from 17.39% before activity to 4.69%. The knowledge mastery rate of internal fistula rose from 52.90% to 91.41%. The qualification rate of internal fistula evaluation rose from 86.23% to 96.88%. The patients’ satisfaction with the puncture technique of nurses increased from 83.33% to 98.44%. There was a statistically significant difference between the two groups before and after the implementation of quality circle control( P<0.05). The annual medical expenses for patients were saved by RMB 40,682.40. The capacity of the members in the quality control circle was significantly improved. Conclusion Through the development of quality control circle activities,the failure rate of puncture at the early stage of internal fistula in hemodialysis patients was effectively reduced and the medical expenses of patients were saved. In addition,the puncture and education methods were innovative,and the supervision mode of hemodialysis patients who exercised at home was created,improve the patient’s satisfaction.更多还原