Department of Nephrology, Affiliated Hai'an Hospital of Nantong University, Hai'an County, Nantong City, Jiangsu Province 226600, China.
Department of Critical Care Medicine, Affiliated Hai'an Hospital of Nantong University, Hai'an County, Nantong City, Jiangsu Province 226600, China.
Biomed Res Int. 2022 Jul 20;2022:7380632. doi: 10.1155/2022/7380632. eCollection 2022.
The survey found that in recent years, with the incidence of chronic kidney disease (CKD) increasing, some patients with CKD even progressed to end-stage renal disease. Luckily, progressive hemodialysis technology and nursing level can improve the quality of life and prognosis of patients.
To explore the application of plan-do-check-adjust (PDCA) cycle in the management of nurses in hemodialysis center and its effect on the maintenance of internal fistula in patients.
In this study, a randomized controlled trail (RCT) was used to select 90 patients who underwent maintenance hemodialysis in the hemodialysis center of our hospital from January 2018 to June 2021 as objects. They were divided into a PDCA group (with PDCA nursing management) and routine group (with routine nursing management) by random number table with each of 45 cases for 6 months to compare the differences of the internal fistula complications, internal fistula maintenance quality, patients' microinflammatory state, and satisfaction with nursing, as well as nursing staff's operational and theoretical performance between the two groups.
There was no significant difference in CRP, IL-1, TNF-, and IL-6 levels between the two groups before intervention ( > 0.05); after that, these levels in the PDCA group were lower than those in the routine group, with statistically significant difference ( < 0.05); before intervention, there was no statistically significant difference in the qualification rate of blood flow, the awareness rate of health education, and the incidence of nursing defects between the two groups ( > 0.05); after that, the qualification rate of blood flow and the awareness rate of health education among nurses in PDCA group were higher than those in routine group, while the incidence of nursing defect accidents in the PDCA group was lower than that in routine group, and the differences were statistically significant ( < 0.05); before intervention, there was no significant difference in the complication rate between the two groups ( > 0.05); after that, the complication rate of the PDCA group was lower than that of the routine group, and the differences were statistically significant ( < 0.05); after intervention, the theoretical assessment and practical skills assessment scores of the PDCA group were higher than those of the routine group, and the differences were statistically significant ( < 0.05); after intervention, the nursing satisfaction of the PDCA group was higher than that of the routine group, and the differences were statistically significant ( < 0.05).
The application of PDCA approach in the management of nurses in hemodialysis centers can effectively improve the quality of internal fistula management and improve the practical and theoretical level of nurses, as well as reduce the microinflammation of patients.
调查发现，近年来，随着慢性肾脏病（CKD）发病率的增加，部分 CKD 患者甚至进展为终末期肾病。幸运的是，渐进性血液透析技术和护理水平可以提高患者的生活质量和预后。
探讨计划-执行-检查-处理（PDCA）循环在血液透析中心护士管理中的应用及其对内瘘维护的影响。
采用随机对照试验（RCT），选取 2018 年 1 月至 2021 年 6 月在我院血液透析中心行维持性血液透析的 90 例患者为研究对象，采用随机数字表法分为 PDCA 组（采用 PDCA 护理管理）和常规组（采用常规护理管理），每组 45 例，护理 6 个月，比较两组患者内瘘并发症、内瘘维护质量、患者微炎症状态、护理满意度以及护理人员操作和理论成绩的差异。
两组患者干预前 CRP、IL-1、TNF-α、IL-6 水平比较差异无统计学意义（>0.05）；干预后 PDCA 组 CRP、IL-1、TNF-α、IL-6 水平均低于常规组，差异有统计学意义（<0.05）；干预前两组护士血流合格率、健康教育知晓率、护理缺陷发生率比较差异无统计学意义（>0.05）；干预后 PDCA 组护士血流合格率、健康教育知晓率高于常规组，护理缺陷发生率低于常规组，差异有统计学意义（<0.05）；干预前两组患者并发症发生率比较差异无统计学意义（>0.05）；干预后 PDCA 组并发症发生率低于常规组，差异有统计学意义（<0.05）；干预后 PDCA 组理论考核和操作技能考核评分均高于常规组，差异有统计学意义（<0.05）；干预后 PDCA 组护理满意度高于常规组，差异有统计学意义（<0.05）。
PDCA 方法在血液透析中心护士管理中的应用，可有效提高内瘘管理质量，提高护士的实践和理论水平，同时降低患者的微炎症反应。
