摘要
目的 探讨品管圈活动在降低内镜黏膜切除术(EMR)术后48 h内低血糖发生率中的应用效果.方法 回顾性选取2023年4月至9月在首都医科大学附属北京世纪坛医院消化内科住院行EMR的胃肠息肉患者600例作为研究对象.将未实施品管圈(2023年4月至6月)的325例患者作为对照组,将实施品管圈(2023年7月至9月)的275例患者作为观察组.对照组按照常规护理进行管理,观察组在对照组的基础上开展品管圈活动.比较两组患者EMR术后48 h内低血糖的发生率及影响因素、生命质量评分的差异,分析开展品管圈活动在降低ERM术后48 h内低血糖中的实践成果.结果 观察组低血糖发生率为4.4％,明显低于对照组(10.8％),差异有统计学意义(P＜0.05).影响低血糖发生率的因素中,观察组输液不合理、摄入不足的患者比例分别为0.7％、1.5％,均低于对照组(4.3％、4.9％),差异均有统计学意义(P＜0.05).干预后,观察组患者生理功能、生理职能、躯体疼痛、一般健康状况、心理健康、精力、社会功能、情感职能评分分别为(86.94±7.32)、(84.18±7.03)、(83.00±5.96)、(82.91±6.39)、(80.42±6.11)、(78.45±7.35)、(82.69±6.72)、(80.71±6.17)分,均明显高于对照组[(81.77±11.67)、(78.09±10.97)、(76.50±9.64)、(76.75±9.86)、(75.80±7.30)、(72.38±9.97)、(76.86±9.97)、(75.94±7.61)分],差异均有统计学意义(P＜0.05).通过此次品管圈活动,圈员们在品管圈手法掌握程度、发现问题能力、个人素质、责任心、组织协调能力、自信心、团队合作精神等方面都取得了进步.结论 通过开展品管圈活动,规范了 EMR的护理流程,降低了 EMR术后48 h内低血糖的发生率,提升了护理人员的专业知识水平、品管圈的手法运用能力和团队协作及质量管理能力.
Abstract
Objective To investigate the effect of quality control circle activities in reducing the incidence of hypoglycemia within 48 hours after endoscopic mucosal resection(EMR)operation.Methods A retrospective study was conducted to select 600 patients with gastrointes-tinal polyp who underwent EMR in the Department of Gastroenterology,Beijing Shijitan Hospital,Capital Medical University from April to Septem-ber 2023.A total of 325 patients without quality control circle(April to June 2023)were selected as the control group,and 275 patients after the implementation of quality control circle(July to September 2023)were selected as the observation group.The control group was managed accord-ing to routine nursing,and the observation group carried out quality control circle activities on the basis of the control group.The incidence and in-fluencing factors of hypoglycemia within 48 hours after EMR were compared between the two groups,and the differences in quality of life score were analyzed.The practical results of quality control circle activities in reducing hypoglycemia within 48 hours after ERM were analyzed.Results The incidence of hypoglycemia in the observation group was 4.4％,which was significantly lower than that in the control group(10.8％),and the differ-ence was statistically significant(P＜0.05).Among the factors affecting the incidence of hypoglycemia,the proportion of patients with unreason-able infusion and insufficient intake in the observation group was 0.7％and 1.5％,respectively,which were lower than those in the control group(4.3％and 4.9％),and the differences were statistically significant(P＜0.05).After intervention,the scores of physiological function,physi-ological function,physical pain,general health status,mental health,energy,social function and emotional function in the observation group were(86.94±7.32),(84.18±7.03),(83.00±5.96),(82.91±6.39),(80.42±6.11),(78.45±7.35),(82.69±6.72),(80.71±6.17)points,respectively,which were significantly higher than those in the control group[(81.77±11.67),(78.09±10.97),(76.50±9.64),(76.75±9.86),(75.80±7.30),(72.38±9.97),(76.86±9.97),(75.94±7.61)points],and the differences were statistically significant(P＜0.05).Through this quality control circle activity,circle members had made progress in their mastery of quality control circle techniques,ability to identify problems,personal qualities,sense of responsibility,organizational and coordination skills,self-confidence,and teamwork spirit.Conclusion By carrying out quality control circle activities,the nursing process of EMR is standardized,the incidence of hypo-glycemia within 48 hours after EMR is reduced,and the professional knowledge level,ability to use the techniques of the quality control circle,teamwork and quality management ability of nursing staff are improved.
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