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PDCA循环在新型冠状病毒肺炎重症监护病房标准化护理管理中的应用

Application of the PDCA cycle for standardized nursing management in a COVID-19 intensive care unit.

作者信息

Chen Yihong, Zheng Jili, Wu Dingyun, Zhang Yuxia, Lin Ying

机构信息

Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Ann Palliat Med. 2020 May;9(3):1198-1205. doi: 10.21037/apm-20-1084.

Abstract

BACKGROUND

Nursing quality is an integral part of health care quality and one of key performance indicators (KPIs) for health care management. The Plan-Do-Check-Act (PDCA) cycle is a management tool for continuous improvement of a business's products or processes. It can be applied to standardize nursing management and thus improve the nursing quality and increase the survival rate of patients. This study assessed the value of the PDCA cycle in standardizing nursing management in an intensive care unit (ICU) for patients with severe coronavirus disease 2019 (COVID-19).

METHODS

The status quo of the ICU was analyzed, and the relevant issues and countermeasures were proposed. The PDCA cycle was applied to standardize the nursing management in the ICU.

RESULTS

Nine measures were proposed and applied to improve the management of the COVID-19 ICU: defining the clean or contaminated areas, use of self-designed shoe storage cabinets, defining staff roles and responsibilities, establishing the staffing structure, staff training, placing items at fixed locations, improving shift handover, use of bulletin boards for listing key points, and use of reserved drugs cabinets. The virus contamination awareness, professional skills, awareness of duties and responsibilities, and quality and performance of nursing were remarkably improved 2 weeks after the implementation of the above countermeasures.

CONCLUSIONS

The PDCA cycle helps to standardize nursing management in COVID-19 ICU by developing and applying effective nursing management approaches.

摘要

背景

护理质量是医疗保健质量的重要组成部分,也是医疗保健管理的关键绩效指标之一。计划-执行-检查-行动(PDCA)循环是一种用于持续改进企业产品或流程的管理工具。它可应用于规范护理管理,从而提高护理质量并提高患者生存率。本研究评估了PDCA循环在为2019年冠状病毒病(COVID-19)重症患者设立的重症监护病房(ICU)中规范护理管理的价值。

方法

分析了ICU的现状,并提出了相关问题及对策。应用PDCA循环对ICU的护理管理进行规范。

结果

提出并应用了九项措施来改善COVID-19 ICU的管理:明确清洁或污染区域、使用自行设计的鞋柜、明确人员角色和职责、建立人员配置结构、员工培训、将物品放置在固定位置、改进交接班、使用公告栏列出要点以及使用备用药品柜。实施上述对策2周后,病毒污染意识、专业技能、职责意识以及护理质量和绩效均有显著提高。

结论

PDCA循环通过制定和应用有效的护理管理方法,有助于规范COVID-19 ICU的护理管理。

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