中国卫生标准管理2024,Vol.15Issue(13) :186-190.DOI:10.3969/j.issn.1674-9316.2024.13.043

PDCA循环管理模式降低围手术期婴幼儿低体温发生率的实证研究

An Empirical Study on PDCA Cycle Management Model to Reduce the Incidence of Hypothermia in Infants During the Perioperative Period

陈秋玉 卓青 方志豪 方团芳 陈金霞 陈雪莲 季彬
中国卫生标准管理2024,Vol.15Issue(13) :186-190.DOI:10.3969/j.issn.1674-9316.2024.13.043

PDCA循环管理模式降低围手术期婴幼儿低体温发生率的实证研究

An Empirical Study on PDCA Cycle Management Model to Reduce the Incidence of Hypothermia in Infants During the Perioperative Period

陈秋玉 1卓青 1方志豪 1方团芳 2陈金霞 1陈雪莲 1季彬3
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作者信息

  • 1. 福建省儿童医院(上海儿童医学中心福建医院)/福建医科大学妇儿临床医学院手术室,福建 福州 350011
  • 2. 福建省儿童医院(上海儿童医学中心福建医院)/福建医科大学妇儿临床医学院麻醉科,福建 福州 350011
  • 3. 上海交通大学医学院附属上海儿童医学中心手术室,上海 200127
  • 折叠

摘要

目的 探讨PDCA循环(plan-do-check-action cycle,PDCA)管理模式应用于降低围手术期患儿低体温发生率的临床价值.方法 选取 2023 年 1-12 月福建省儿童医院(上海儿童医学中心福建医院)治疗的 296 例围手术期患儿为研究对象,将其分为对照组(2023 年 1-6 月患儿)与试验组(2023 年 7-12 月患儿),各 148 例.对照组采用常规手术护理模式,试验组采用PDCA循环质量改进法护理模式.比较 2 组患儿围手术期低体温的发生情况.结果 2 组患儿年龄、性别、体质量、科室类别及麻醉完成时体温比较,差异均无统计学意义(P>0.05).试验组在术中 30、90、120 min低体温发生率要优于对照组(3.38%vs.10.12%,4.73%vs.13.51%,7.43%vs.15.54%),差异有统计学意义(P<0.05).术中 60 min、术后 30 min的低体温发生率(4.05%vs.8.78%,1.35%vs.2.03%)比较,差异无统计学意义(P>0.05).2 组患儿术后发生手术切口感染、心血管不良事件和凝血功能下降的总发生率分别为 12.50%、2.36%和 10.81%,其中试验组的手术切口感染率(6.08%vs.18.92%)和凝血功能下降发生率(6.08%vs.15.54%)均优于对照组,差异有统计学意义(P<0.05).试验组麻醉苏醒时间、住院时间明显优于对照组(P<0.05).2 组心血管不良事件发生率比较(1.35%vs.3.38%),差异无统计学意义(P>0.05).结论 PDCA循环质量改进法可以降低围手术期患儿低体温发生率及术后相关不良事件,具有一定的临床价值.

Abstract

Objective To explore the clinical application value of the PDCA cycle(plan-do-check-act cycle,PDCA)management model in reducing the incidence of hypothermia during the perioperative period for infants.Methods A total of 296 infants treated during the perioperative period at Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center)from January to December 2023 were selected as research subjects.These infants were divided into a control group(children from January to June 2023)and an experimental group(children from July to December 2023),with 148 cases each group.The control group received conventional surgical care,while the test group adopted the PDCA cycle quality improvement method for nursing.The occurrence of hypothermia during the perioperative period between the two groups of infants were compared.Results There was no statistically significant difference between the two groups of children in terms of age,gender,weight,department category,and body temperature upon completion of anesthesia(P>0.05).However,at 30,90,120 min during surgery,the incidence of hypothermia in the test group was significantly better than that in the control group(3.38%vs.10.12%,4.73%vs.13.51%,and 7.43%vs.15.54%),with a statistically significant difference(P<0.05).There was no significant difference between the two groups in terms of the incidence of hypothermia at 60 min during surgery and 30 min postoperatively(4.05%vs.8.78%,1.35%vs.2.03%),with no statistically significant difference(P>0.05).The total incidence rates of postoperative surgical wound infection,cardiovascular adverse events,and decreased coagulation function in both groups of infants were 12.50%,2.36%,and 10.81%.The test group performed significantly better than the control group in terms of the incidence of these adverse events(respectively 6.08%vs.18.92%and 6.08%vs.15.54%),with a statistically significant difference(P<0.05).In terms of anesthesia recovery time and hospital stay,the test group also performed significantly better than the control group(P<0.05).However,there was no significant difference between the two groups in terms of the incidence rate of cardiovascular adverse events(1.35%vs.3.38%)(P>0.05).Conclusion The PDCA cycle quality improvement method can effectively reduce the incidence of hypothermia during the perioperative period for infants and related adverse events after surgery,demonstrating its certain clinical application value.

关键词

PDCA/围手术期/婴幼儿/低体温/管理/护理模式

Key words

PDCA/perioperative period/infant/hypothermia/management/nursing mode

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基金项目

福建省自然科学基金资助项目(2023J011321)

福建省儿童医院科技创新启动基金(新竹青年护理人才培养计划)资助项目(儿童YCXH202201)

出版年

2024
中国卫生标准管理
《中国卫生标准管理》杂志社

中国卫生标准管理

影响因子:1.374
ISSN:1674-9316
参考文献量9
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