高士杰 管蕊 董南君 徐丹

[摘要] 目的 分析FOCUS-PDCA管理模式對行乳腺肿物微创旋切术患者术后恢复与并发症发生的影响。 方法 将2015年1月～2017年6月辽宁省抚顺市中心医院收治的100例行乳腺肿物微创旋切术治疗的患者随机分为观察组和对照组，每组各50例。对照组采用常规护理管理模式干预，观察组采用FOCUS-PDCA管理模式干预。对两组患者住院时间、住院费用、健康知识知情情况、满意度、分级护理落实合格率及健康教育合格率进行调查，出院前调查患者肿胀程度，出院3个月时分别采用QLQ-C30量表及症状自评量表评估患者的生活质量及心理状态。 结果 观察组住院时间、住院总费用、并发症发生率显著低于对照组，差异有统计学意义（P < 0.05）。观察组健康知识知晓率、分级护理落实合格率、患者满意度、健康教育合格率、乳房肿胀程度、生活质量评分、心理状态评分显著优于对照组，差异有统计学意义（P < 0.05）。 结论 FOCUS-PDCA管理模式可有效提高乳腺肿物微创旋切术患者的术后恢复治疗情况，并降低术后并发症发生率。

[关键词] FOCUS-PDCA管理模式；微创旋切术；术后恢复；并发症

[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-7210（2018）02（a）-0169-04

Effect of FOCUS-PDCA management mode on postoperative recovery and the occurrence of complications in patients with minimally invasive rotary varicotomy for breast mass

GAO Shijie1 GUAN Rui2 DONG Nanjun1 XU Dan2

1.Department of Surgery， Fushun Central Hospital， Liaoning Province， Fushun 113006， China； 2.Department of Internal Medicine， Fushun Central Hospital， Liaoning Province， Fushun 113006， China

[Abstract] Objective To analyze the influence of FOCUS-PDCA management mode on postoperative recovery and the occurrence of complications in patients with minimally invasive rotary varicotomy for breast mass. Methods One hundred cases of patients with minimally invasive rotary varicotomy for breast mass admitted to Fushun Central Hospital in Liaoning Province from January 2015 to June 2017 were randomly divided into observation group and control group， with 50 cases in each group. The control group received routine nursing management mode， the observation group received the FOCUS-PDCA management mode. The hospital stay， hospitalized expense， informed conditions of healthy knowledge， satisfaction degree， the qualified rate of implementation of grading nursing and the qualified rate of health education in the two groups were investigated. The swelling degree of patients was investigated before discharge， and the QLQ-C30 scale and symptom checklist were respectively used to evaluate the quality of life and psychological status after discharge for 3 months. Results The hospital stay， total hospitalized expense， and the incidence of complications in the observation group were significantly lower than those of control group， the differences were statistically significant （P < 0.05）， and the awareness rate of health knowledge， the qualified rate of implementation of grading nursing， satisfaction degree of patients， the qualified rate of health education， the breast swelling degree， the scores of quality of life and psychological status in the observation group were all significantly better than those of control group， the differences were statistically significant （P < 0.05）. Conclusion FOCUS-PDCA management mode can effectively improve the postoperative recovery treatment conditions of patients with minimally invasive rotary varicotomy for breast mass and reduce the incidence of postoperative complications.

[Key words] FOCUS-PDCA management mode； Minimally invasive rotary varicotomy； Postoperative recovery； Complications

我国乳腺疾病的临床发病率逐渐升高，微创手术是目前治疗乳腺疾病的常见治疗方法，当由于患者发病部位相对特殊，常会给患者造成恐惧、焦虑、紧张等诸多负面情绪[1-2]。术后患者也常出现肿胀、渗血、感染或青紫等症状[3]。目前在对行乳腺肿物微创旋切术治疗患者的护理工作中常存在不容忽视的问题，如健康宣教不足、巡视不及时等，对患者的术后恢复质量产生诸多不良影响[4]。PDCA循环最开始在企业管理中广泛应用，后在质量管理过程中逐步得到应用，目前成为公认的有效的质量管理及工作程度管理的方法之一[5]。后有学者在PDCA的基础上进一步改进和延伸发展出FOCUS-PDCA程序，可更为全面地了解并控制各环节，实现持续质量改进的目的[6]。……