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目的观察精益六西格玛管理在呼吸重症监护室(RICU)气管插管非计划性拔管(UEX)中的应用效果。方法通过精益六西格玛管理理论,预见性排列流程中的失效环节,评估不同的失效模式,找出此环节中最需要改进的部分(镇静不充分、约束不当、导管固定不当、操作不当),制定改进措施,加以实施。结果 2014年度实行精益六西格玛管理后,UEX发生为2.9%(6/208),较2013年度的13.0%(28/215)明显下降,高危时段UEX发生例数明显下降。结论精益六西格玛管理能有效减少RICU非计划性拔管率,提升医疗护理质量。
Objective To observe the application effect of Lean Six Sigma in respiratory unconventional extubation (UEX) of respiratory intensive care unit (RICU). Methods The Lean Six Sigma theory was used to predict the failure stages in the process of foreseeability, to evaluate the different failure modes, to find out the most needed improvements in this session (inadequate calm, inadequate restraint, improper catheterization, improper operation), development of improvements Measures to be implemented. Results After implementing Lean Six Sigma in 2014, UEX occurred at 2.9% (6/208), significantly lower than 13.0% (28/215) in 2013, and the number of cases of UEX decreased significantly during the high-risk period. Conclusion Lean Six Sigma can effectively reduce the unplanned extubation rate of RICU and improve the quality of medical care.