Application of continuous quality improvement combined with nursing quality indicators in reducing arteriovenous fistula puncture injury
ObjectiveTo explore the role of continuous quality improvement and nursing quality indicators in nurs-ing practice to reduce the incidence of arteriovenous fistula puncture injury.Method Taking reducing the incidence of arteriovenous fistula puncture injury as the goal of quality control,patients who used arteriovenous fistula as a vas-cular access in the hemodialysis room of Peking University People's Hospital in August and November 2022 were se-lected as the research subjects.Patients treated before quality improvement in August were selected as the control group,and patients treated after quality improvement in November were selected as the observation group.The inci-dence of arteriovenous fistula puncture injury,the proportion of various fistula puncture methods,the usage rate of vascular ultrasound,and patient satisfaction with puncture were used as nursing quality indicators.The results and causes of the indicators were summarized and analyzed monthly,and targeted nursing quality management and im-provement measures were implemented.Results A total of 1,810 punctures were performed in 123 patients in the control group,with 10 cases of puncture injuries,and the incidence of arteriovenous fistula puncture injuries was 0.55％(10/1,810);There were a total of 125 patients in the observation group,with 1,733 punctures and 3 inju-ries,and the incidence of arteriovenous fistula puncture injuries was 0.17％(3/1,733).The incidence of difficult vascular access puncture injury decreased(P=0.039),and the proportion of rope ladder puncture increased to 63％.The use of vascular ultrasound increased from 5/123(4％)to 125/125(100％,P＜0.001),and patient satis-faction with puncture significantly increased(P＜0.001).Conclusion The combined application of specialized nursing quality indicators for hemodialysis and the implementation of continuous quality improvement management can signif-icantly reduce the incidence of arteriovenous fistula puncture injuries.
hemodialysisnursing sensitive quality indicatorarteriovenous fistulainjury from cannula-tionnursing quality control
万方数据
维普
