张红英　何剑　秦雪燕　魏雪梅

[摘要] 目的 探討品管圈活动在综合性ICU患者头部压疮管理中的应用及效果。方法 选取2018年8—12月实施品管圈活动前，在ICU住院的高危压疮患者139例为对照组;选取2019年1—5月在品管圈活动开展下，在ICU住院的高危压疮患者135例为观察组。比较品管圈活动前后两组的难免压疮申报率、头部压疮的发生率、住院患者满意度及圈成员活动能力情况。结果 患者的难免压疮申报率差异无统计学意义（P>0.05），观察组的头部压疮发生率低于对照组，观察组住院患者满意度、圈成员活动能力高于对照组，差异有统计学意义（P<0.05）。结论 在ICU患者头部压疮管理中实施品管圈活动，可以有效降低ICU患者头部压疮发生率，提高住院患者满意度，增强圈成员活动能力。

[关键词] 品管圈;危重患者;头部压疮

[中图分类号] R47 [文献标识码] A [文章编号] 1672-5654（2020）07（b）-0060-05

Application of Quality Control Circle in the Management of Head Pressure Ulcers in Comprehensive ICU Patients

ZHANG Hong-ying1， HE Jian2， QIN Xue-yan1， WEI Xue-mei1

1.Department of Critical Care Medicine， Affiliated Hospital of North Sichuan Medical College， Nanchong， Sichuan Province， 637000 China; 2.Office of Affiliated Hospital of North Sichuan Medical College， Nanchong， Sichuan Province， 637000 China

[Abstract] Objective To explore the application and effect of quality control circle activities in the management of head pressure ulcers in comprehensive ICU patients. Methods 139 patients with high-risk pressure ulcers hospitalized in the ICU from August to December 2018 before the implementation of the quality control circle activities were selected as the control group; selected from January to May 2019 under the quality control circle activities， 135 patients with high-risk pressure ulcers hospitalized in the ICU were in the observation group. Compare the inevitable pressure ulcer declaration rate， the incidence of head pressure ulcers， the satisfaction of hospitalized patients and the activity ability of the circle members of the two groups before and after the quality control circle activity. Results There was no statistically significant difference in the reporting rate of inevitable pressure ulcers in patients（P>0.05）. The incidence of head pressure ulcers in the observation group was lower than that in the control group. The satisfaction degree of hospitalized patients and the activity ability of circle members in the observation group were higher than those of the control group. The difference was statistically significant（P<0.05）. Conclusion The implementation of quality control circle activities in the management of head pressure ulcers in ICU patients can effectively reduce the incidence of head pressure ulcers in ICU patients， improve the satisfaction of inpatients， and enhance the mobility of circle members.

[Key words] Quality control circle; Critically ill patients; Head pressure sores

压疮（pressure ulcer）指皮肤和（或）皮下组织的局限性损伤，通常位于骨隆突处，由压力（包括压力联合剪切力）所致，临床常见的慢性难愈性创面，压疮的发生会加重患者病情、延缓康复、增加痛苦和经济负担[1-3]。由于病情重，常有躯体移动及感觉功能受限，血液循环不畅、全身营养不良，加上焦虑、多汗、大小便失禁等因素，ICU患者是头部压疮的高危人群[4]。临床工作往往习惯于防范患者髋部、骶尾部及足跟部位压疮的发生，而忽略了头部压疮的预防。

品质管理圈（quality control circle，QCC）简称“品管圈”，指同一个工作场所的人，自发地组成一个小团体，通过一系列步骤的实施来解决某个问题，从而改善工作流程或改进工作方法、提高工作效率，改善服务质量和服务意识，促进自发性的实施管理[5-7]。目前，品管圈被广泛运用到呼吸机相关性肺炎、导管相关性尿路感染等多个领域，取得了良好效果，但鲜见品管圈运用于头部压疮的相关报道。亟待……