| 杨卫华.基于PDCA循环的临床护理路径在支气管镜检查患者中的应用[J].中国药事,2018,32(2):287-294 |
| 基于PDCA循环的临床护理路径在支气管镜检查患者中的应用 |
| One the Application of Clinical Nursing Path Based on the PDCA Cycle in Patients with Bronchoscopy |
| 投稿时间：2016-10-14 |
| DOI：10.16153/j.1002-7777.2018.02.022 |
| 中文关键词: PDCA循环 临床护理路径 支气管镜检查 满意度 |
| 英文关键词: PDCA cycle clinical nursing path bronchoscopy satisfaction |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨基于PDCA循环的临床护理路径在支气管镜检查患者中的应用。方法：选取2013年9月至2016年9月期间我院确诊治疗的支气管镜检查患者200例。依据是否实施了PDCA循环的临床护理路径分为循环路径组和常规组，每组100例。常规组患者于2013年9与之2014年6月给予常规护理干预；循环路径组患者在此基础上于2014年7月至2016年9月期间实施了基于PDCA循环的临床护理路径干预。所有患者于麻醉后评估麻醉效果和耐受程度，采用汉密尔顿焦虑量表（HAMA）评估患者焦虑状态；采用本院自制的《患者疾病及支气管检查知识量表》评估患者知识了解程度；采用本院自制的《支气管检查满意度调查问卷》评估患者对护理的满意程度；采用本院自制的《医护人员支气管检查技能知识问卷》评估医护人员技能掌握程度，统计分析所有患者的麻醉效果、耐受程度、知识了解程度、护理满意程度、平均住院日、按期检查情况和入院时、检查前、检查开始时、检查后的焦虑状态及实施PDCA前后医护人员技能掌握程度。结果：循环路径组患者麻醉优良率和耐受优良率明显高于常规组；循环路径组患者知识了解率明显高于常规组；循环路径组患者护理满意率明显高于常规组；循环路径组患者平均住院日和检查前、检查开始时、检查后的HAMA得分明显低于常规组，前者按期检查率明显高于后者；实施PDCA后医护人员技能掌握率明显高于实施前，上述指标均有统计学意义（P < 0.05）。结论：基于PDCA循环的临床护理路径干预可有效改善支气管镜检查患者麻醉效果和耐受程度，提高患者知识了解程度和护理满意程度，可有效缓解患者检查期间的焦虑状态，有利于患者按期进行检查和缩短住院时间，且可有效提高医护人员的技能知识水平，值得临床进一步推广。 |
| 英文摘要: |
| Objective: To discuss the application of clinical nursing path based on the PDCA cycle in patients with bronchoscopy. Methods: A total of 200 patients with bronchoscopy admitted in our hospitals from September 2013 to September 2012 were selected for the study. According to whether implementing clinical nursing path based on PDCA cycle and random distribution or not, all patients were divided into circular path group and conventional group, with 100 cases in each group. Patients of conventional group were given routine nursing intervention between September 2013 and June 2013. The patients of circular path group were given clinical nursing path based on PDCA cycle intervention between July 2014 to September 2016. The anesthesia effect and tolerability after anesthesia were evaluated in all patients. The Hamilton anxiety scale (HAMA) was used to evaluate the anxiety state of the patients. The "patient's disease and bronchial check knowledge scale" made by our hospital used to assess patients understanding knowledge, and the "Questionnaire on bronchial check satisfaction" made by our hospital was used to evaluate patients' satisfaction with care. The ‘Questionnaire on Technical knowledge of bronchography among Medical staff’ made by our hospital was used to evaluate how much technical knowledge the medical staff have grasped. Patients' anesthesia effect and tolerability, the level of the knowledge, the degree of nursing satisfaction, the average length of hospitalization, the regular checkup and the degree of anxiety before and after the examination, and the skill level of the medical staff before and after the implementation of PDCA were analyzed by the questionnaire. Results: The excellent rate of anesthesia and the rate of excellent tolerance were signifcantly higher in the patients of the circulation path group than those in the conventional group. The knowledge rate of the patients in the circulation path group was signifcantly higher than that in the conventional group. The patient satisfaction rate in the circulation path group was signifcantly higher than that in the conventional group. The average rate of HAMA in the circulation path group was signifcantly lower than that of the conventional group at the beginning of hospitalization and at the beginning of the examination, and the rate of regular check-up was signifcantly higher than that of the latter. The rate of mastering technical knowledge among the medical staff was signifcantly higher after the implementation of PDCA than that before the implementation. All the above was statistically signifcant (P < 0.05). Conclusion: PDCA cycle-based clinical nursing pathway intervention can effectively improve the anesthesia effect and tolerance of bronchoscopy patients, improve the degree of knowledge of patients and the degree of nursing satisfaction, effectively alleviate the anxiety state of patients during examination, help patients to check regularly, shorten the hospital stay, and can effectively improve the knowledge level of medical staff. It is worth further clinical promotion. |
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