本文已被:浏览 268次 下载 320次
Received:June 29, 2023 Published Online:May 20, 2024
Received:June 29, 2023 Published Online:May 20, 2024
中文摘要: 目的 探讨品管圈管理对肩关节镜手术患者围手术期低体温发生率的影响。 方法 选取2022年5月至9月在徐州市中心医院行肩关节镜手术的患者为研究对象,2022年5月前手术的118例为品管圈管理实施前组,2022年5月至9月手术的118例为实施后组。成立品管圈团队,对实施前组患者发生低体温的原因进行分析,通过圈能力设定目标值,确定评估不完善、液体未加温、保温用具使用不当、手术单潮湿为围术期低体温的主要原因,制定出针对性的一系列创新保温策略(包括发明肢体保暖护套和躯体约束带两项专利),并在实施后组患者中实施,效果确认后列为标准化。 结果 通过实施品管圈管理,肩关节镜手术患者围术期低体温发生率由实施前的50.9%下降到19.5%,差异有统计学意义(χ2=25.442,P<0.01);患者复苏期间寒颤发生率下降,复苏时间明显缩短,术后各种并发症发生率降低,差异有统计学意义(P<0.01)。 结论 品管圈管理可有效降低肩关节镜手术患者围手术期低体温发生率,减少患者术后并发症,并通过手术室平台来促进护理工作,对专科及亚专科护理质量管理起到促进作用。
Abstract:Objective To explore the effect of quality control circle (QCC) management on the incidence of perioperative hypothermia in patients undergoing shoulder joint surgery. Methods Patients who underwent shoulder arthroscopic surgery at Xuzhou Central Hospital from May to October 2022 were selected as the research subjects. A total of 118 patients who underwent surgery before May 2022 were selected as the pre-implementation group of QCC management, and 118 patients who underwent surgery from May to September 2022 were selected as the post-implementation group. A QCC team was established to analyze the causes of hypothermia of the pre-implementation group of patients. By setting target values based on the circle's ability, the main causes of perioperative hypothermia as incomplete evaluation, unheated liquids, improper use of insulation equipment, and wet surgical sheets were identified. A series of targeted innovative insulation strategies (including two patents for inventing limb thermal sheath and body restraint belt) were developed and implement them in the post-implementation group of patients,and after confirming the effectiveness,these insulation strategies were standardized. Results Through the implementation of QCC management, the incidence of perioperative hypothermia in patients undergoing shoulder arthroscopic surgery had decreased from 50.9% before implementation to 19.5%, with a statistically significant difference (χ2=25.442, P<0.01). The incidence of shivering during patient resuscitation decreased, the recovery time significantly shortened, and the incidence of various postoperative complications decreased, with a significant difference (P<0.01). Conclusion QCC management can effectively reduce the incidence of perioperative hypothermia in patients undergoing shoulder arthroscopic surgery, reduce postoperative complications, and promote nursing work through the operating room platform, playing a promoting role in the quality management of specialized and sub-specialized ursing.
keywords: Quality control circle Shoulder arthroscopic surgery Hypothermia Preheating Warm sleeve for extremities
文章编号: 中图分类号:R472.3 文献标志码:B
基金项目:徐州市科技项目(KC22156);徐州医科大学附属医院发展基金资助项目(XYFY202202)
引用文本: