摘要
目的探讨6S结合PDCA循环精益化管理在创伤骨科手术护理管理中的应用效果。方法采用回顾性队列研究分析2020年1月至2021年11月重庆医科大学附属大学城医院收治的80例创伤骨科患者的临床资料,其中男51例,女29例;年龄23~68岁[(44.5±9.2)岁]。按照手术日期的先后顺序分组,2021年1月至2021年11月的40例患者接受创伤护理和6S结合PDCA循环精益化管理(精益化管理组);2020年1月至2020年12月的40例患者接受常规手术护理管理(常规管理组)。比较两组手术室护理管理质量量表(仪器设备管理、手术器械准备、手术操作配合和消毒隔离措施)、手术室感染监测合格率(手术室空气、医护人员手卫生及手术无菌物品)及手术医师对当台护士(巡回、器械护士)的满意度、术前患者焦虑自评量表(SAS)、术后12 d并发症发生率(压力性损伤、深静脉血栓、肺部感染、切口感染等)及术后2~3 d回访时患者对手术室护士工作的满意度。结果精益化管理组手术室护理管理质量量表的4个维度评分分别为(27.8±1.5)分、(18.1±1.1)分、(26.6±1.5)分、(18.1±0.8)分,明显高于常规管理组的(23.7±2.3)分、(14.6±1.1)分、(22.4±1.8)分、(13.7±1.1)分(P均<0.01)。精益化管理组手术室感染监测合格率的3个方面均为100%,与常规管理组(75%、100%和100%)差异无统计学意义(P均>0.05)。精益化管理组手术医师对巡回护士、器械护士的满意度分别为90%、85%,高于常规管理组的73%、65%(P均<0.05)。精益化管理组术前SAS为(32.5±8.2)分,明显低于常规管理组的(54.6±10.7)分(P<0.01)。精益化管理组术后并发症发生率为0,明显低于常规管理组的15%(6/40)(P<0.05)。精益化管理组患者对手术室护士工作的满意度为95%(38/40),明显高于常规管理组的78%(31/40)(P<0.05)。结论6S结合PDCA循环精益化管理能有效提升创伤骨科手术护理管理质量,改善患者焦虑情绪,减少术后并发症,提高手术医师和患者满意度,值得临床进一步推广应用。
Objective To explore the application effect of 6S and PDCA cycle lean management in nursing management of orthopaedic trauma surgery.Methods A retrospective cohort study was conducted to analyze the clinical data of 80 patients with orthopedic trauma admitted to University-Town Hospital of Chongqing Medical University from January 2020 to November 2021,including 51 males and 29 females;aged 23-68 years[(44.5±9.2)years].According to the order of operation date,40 patients from January 2021 to November 2021 received routine management plus 6S and PDCA cycle lean management(lean management group),and 40 patients from January 2020 to December 2020 received routine surgical nursing management(routine management group).The nursing quality score in operating room(instrument and equipment management,surgical instrument preparation,surgical coordination,disinfection and isolation),qualified rate of infection monitoring in operating room(air in operating room,hand hygiene of medical staffs and sterile articles in operating room),surgeons′satisfaction with operating nurses(circulating nurses and scrub nurses),self-rating anxiety scale(SAS)of patients before operation,incidence of complications at postoperative 12 days and patients′satisfaction with nurses in operating room at postoperative 2-3 days.Results The four dimensions of the nursing quality score in operating room in lean management group were(27.8±1.5)points,(18.1±1.1)points,(26.6±1.5)points and(18.1±0.8)points,significantly higher than(23.7±2.3)points,(14.6±1.1)points,(22.4±1.8)points and(13.7±1.1)points in routine management group(all P<0.01).The three dimensions of qualified rate of infection monitoring in operating room in lean management group were all 100%,showing no significant differences in routine management group(75%,100%,100%)(all P>0.05).Surgeons′satisfaction with circulating nurses and scrub nurses in lean management group was 90%and 85%,higher than 73%and 65%in routine management group(all P<0.05).Preoperative SAS in lean management group was(32.5±8.2)points,significantly lower than(54.6±10.7)points in routine management group(P<0.01).The incidence of postoperative complications in lean management group was 0,significantly lower than 15%(6/40)in routine management group(P<0.05).Patients′satisfaction with nurses in operating room in lean management group was 95%(38/40),significantly higher than 78%(31/40)in routine management group(P<0.05).Conclusion 6S and PDCA cycle lean management can effectively improve the nursing quality of orthopedic trauma surgery,reduce patients′anxiety and postoperative complications,and improve surgeons′and patients′satisfaction,which is worthy of further clinical application.
作者
程瑜
赵佳
冉娅莉
唐莹莹
罗柳
向彦岭
Cheng Yu;Zhao Jia;Ran Yali;Tang Yingying;Luo Liu;Xiang Yanling(Department of Nursing,University-Town Hospital of Chongqing Medical University,Chongqing 401331,China;Department of Surgical Anesthesiology,University-Town Hospital of Chongqing Medical University,Chongqing 401331,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2022年第5期452-457,共6页
Chinese Journal of Trauma
关键词
骨折
手术室护理
护理管理
Fractures,bone
Operating room nursing
Nursing care management
作者简介
通信作者:向彦岭,Email:282223591@qq.com,电话:15823373685。
