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目的应用品管圈提高中心静脉导管集束化干预策略实施依从性,以便控制中心静脉导管相关性血流感染。方法成立品管圈,确立“降低集束化干预下中心静脉导管相关性血流感染(CRBSI)”为活动主题,进行现况调查、要因分析、拟定对策、运用PDCA循环的原则进行对策的实施和效果核查、标准化处置等。结果按照品管圈的活动完成后,中心静脉导管集束化干预策略实施依从性从54.05%上升到77.97%。追踪2014年6月至2014年11月入住ICU并行中心静脉置管患者159例,CRBSI感染发生率为5.3‰,与实施前(9.1‰)相比差异有统计学意义(P<0.01)。结论开展品管圈活动,进一步提升了中心静脉导管集束化干预策略实施依从性,降低了中心静脉导管相关性血流感染。规范了临床护理工作,使护理工作质量持续改进,同时提高了护理人员工作的积极性,相互沟通的能力,提升了团队的凝聚力和自信心。
Objective To improve the compliance of central venous catheter bundling intervention strategies for the control of central venous catheter-related bloodstream infections. Methods A quality control circle was set up to establish the theme of “Reducing central venous catheter-related bloodstream infection (CRBSI) under cluster intervention” as the theme of the activity. The current status was investigated, and the measures were to be taken due to the analysis and formulation of countermeasures, using the principle of PDCA cycle Implementation and effectiveness verification, standardization disposal and so on. Results Following the completion of QA activities, compliance with central venous catheterization intervention increased from 54.05% to 77.97%. A total of 159 ICU patients admitted to the center of ICU from June 2014 to November 2014 were followed up. The incidence of CRBSI infection was 5.3 ‰, which was significantly different from that before implementation (9.1 ‰) (P <0.01). Conclusion Conducting QA activities further enhanced compliance with central venous catheterization intervention and reduced central venous catheter-related bloodstream infections. Standardize the clinical nursing work, the quality of nursing work continued to improve, while improving nurse work enthusiasm, mutual communication ability, enhance the cohesion and self-confidence of the team.