孙杰++刘炳兰++雷员华

[摘要]目的 探討PDCA循环理论在儿科静脉留置针管理中的应用效果。方法 选取2014年1月～2015年12月行外周静脉留置针治疗的患儿180例为研究对象，以2014年1～12月PDCA循环理论应用前的90例为对照组，以2015年1～12月PDCA循环理论应用后的90例为观察组。对照组采取常规静脉留置针护理方法，观察组采取PDCA循环理论进行护理干预，比较两组患儿静脉留置针的留置时间、非计划拔管率、留置针相关并发症和家属满意度。结果 观察组患儿静脉留置针留置时间为（92.78±3.45）h长于对照组（87.96±4.62）h，观察组患儿非计划拔管率及留置针相关并发症发生率分别为3.3%和6.6%，低于对照组的18.9%和22.2%，观察组患儿家属满意度为97.8%，高于对照组的86.7%，差异均有统计学意义（P<0.05）。结论 采用PDCA循环理论对静脉留置针患儿进行护理，能够延长静脉留置针的留置时间，降低非计划拔管率和留置针相关并发症发生率，提高患儿家属对治疗护理的满意度。

[关键词]PDCA；儿科；留置针；护理管理

[中图分类号] R248.4 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0178-04

Application of PDCA cycle theory in the management of pediatric peripheral venous infusion with indwelling needle

LIU Li1 CAI Shan-shan2 PENG Fei-yan2

1.Department of Nursing，People′s Hospital of Jiexi County in Jiexi City，Guangdong Province，Jiexi 515400；2.Department of Pediatrics， People′s Hospital of Jiexi County in Jiexi City，Guangdong Province，Jiexi 515400，China

[Abstract]Objective To explore the application effect of PDCA cycle theory in the management of pediatric peripheral venous infusion with indwelling needle.Methods A total of 180 children undergoing treatment of peripheral venous indwelling needle from January 2014 to December 2015 were selected as research objects.90 cases before application of PDCA cycle theory from January to December 2014 were taken as control group，while 90 cases after application of PDCA cycle theory from January to December 2015 were taken as observation group.Children in control group were given routine nursing care，while children in observation group were given nursing management based PDCA cycle theory.The retention time，unplanned extubation rate，catheter-related complications and nursing satisfaction were compared between the two groups.Results The retention time of indwelling needle in observation group was （92.78±3.45）h longer than that in control group of （87.96±4.62） h；the unplanned extubation rate and catheter-related complications rate in observation group were 3.3% and 6.6% respectivly both lower than those in control group（18.9% and 22.2%）；the nursing satisfaction in observation group was 97.8% higher than that in control group of 86.7%，the difference was statistically significant（P<0.05）.Conclusion The application of PDCA cycle theory in pediatric peripheral indwelling needle can extend the retention time，reduce unplanned extubation rate and catheter-related complication rate， and improve nursing satisfaction.

[Key words]PDCA；Pediatric；Indwelling needle；Nursing management

外周静脉留置针能够减少因反复穿刺对血管的损伤，较长时间内维持静脉通道，减轻患儿的身心痛苦和护士的工作量，因此在儿科已被广泛应用[1-2]。由于患儿哭闹、不配合、年龄小不能明确表达需求，给儿科静脉留置针护理管理工作提出挑战。如果静脉留置针留置期间护理不当，不但会影响其留置时间，还会引起静脉炎等相关并发症，导致护理质量下降，甚至引起护患纠纷[3]。PDCA循环理论是由美国质量管理专家戴明提出的一种科学的管理方法，即计划（P）、执行（D）、检查（C）、处理（A）4个步骤循环进行[4]。大量研究表明，PDCA循环理论能够提高护理质量[5-8]。本研究将PDCA循环理论应用到儿科外周静脉留置针的护理管理中，旨在探討其对提高儿科静脉留置针管理的护理效果，现报道如下。……