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刘佐嘉,陆华,任素琴.PDCA循环管理在保护婴幼儿机械通气颜面皮肤效果应用[J].上海护理,2016,16(7):
PDCA循环管理在保护婴幼儿机械通气颜面皮肤效果应用
DOI：
中文关键词:  PDCA,水胶体敷料,机械通气,PICU护理,WOC伤口造口失禁治疗师
英文关键词:PDCA, hydrocolloid dressing, mechanical ventilation,WOC,PICU
基金项目:
作者单位E-mail
刘佐嘉 上海市儿童医学中心 liusaka@gmail.com 
陆华 上海市儿童医学中心  
任素琴* 上海市儿童医学中心 rensqin@sina.com 
摘要点击次数: 2022
全文下载次数: 0
中文摘要:
      目的：通过PDCA（Plan Do Check Act）持续质量改进循环管理模式，提高水胶体敷料对气管插管患儿颜面皮肤的保护效果。方法：PICU病区护士长担任项目负责人，旨在减少因水胶体敷料介入程序的不规范而导致机械通气患儿颜面皮肤保护效果的差异。项目基于PDCA循环管理理论，遵循5个阶段包括准备，宣传，程序化，评估以及改进。机械通气患儿颜面皮肤问题进行统计学分析，并且与回顾性的数据资料进行比较。结果：①通过PDCA项目介入机械通气患儿应用水胶体敷料（包括有创机械通气和无创机械通气），颜面问题发生率从57% t降至21%。项目提高了水胶体敷料的保护效果(P<0.05)。②建立水胶体敷料介入气管插管流程以及CPAP无创机械通气颜面皮肤保护固定标准。③因项目而创建的评估记录单作为一项工具有助于护理。结论：PDCA循环管理有效改进了水胶体敷料对机械通气患儿颜面皮肤保护的应用效果。
英文摘要:
      OBJECTIVE: To improve the hydrocolloid dressing protecting pediatric patients’ facial region with mechanical ventilation via a PDCA(Plan Do Check Act) program basing on the methodology for continuous improvement cycle. MATERIALS AND METHODS: The charge nurse of PICU decided to developing a grogram to decrease the variability of hydrocolloid dressing applying. The program was based on the methodology PDCA and followed 5 phases including preparation, processing, dissemination, evaluation and updating. The facial region problems with mechanical ventilation were statisticaly analyzed and was compared with the historical data. RESULTS:①Via PDCA program among the pediatric patients who got mechanical ventilation(including invasive and noninvasive), the frequency of facial region’s problem dropped from 57% to 21%. The program improved the effectiveness of hydrocolloid dressing protecting protocol(P<0.05).②The criteria and standard procedure of applying hydrocolloid dressing in fixing trachea cannula and nasal continuous positive airway pressure (NCPAP) have been created.③Assessment record sheet which was created during the program did good to nursing care as a tool. CONCLUSION: PDCA methodologies can have significant effects on improving the hydrocolloid dressing protecting facial region of the pediatric patients who get mechanical ventilation.
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主管单位：上海市卫生健康委员会   主办单位：上海市护理学会  出版：《上海护理》编辑部
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