Ren Danqing, Zang Lele, Chen Wenyuan, Huang Hailian, Lin Mei, Li Suyu, Lin Na, Huang Qiuyuan
Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, China.
Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, 350014, China.
Support Care Cancer. 2024 Dec 28;33(1):59. doi: 10.1007/s00520-024-09106-w.
This study aims to enhance compliance with lower limb lymphedema (LLL) prevention care measures post-gynecologic oncology surgery (GOS) through quality control circle (QCC) activity, aiming to improve patient recovery outcomes and reduce postoperative complications.
A 6-month QCC activity was conducted within the hospital, employing the ten-step plan-do-check-act model for QCC activity. The root causes of inadequate implementation of LLL prevention care measures were analyzed, leading to the development of relevant strategies and protocols. Compliance rates of preventive care measures pre- and post-QCC activity were compared.
The focus of this improvement initiative was on "inadequate postoperative preventive measures" and "lack of standardized discharge preventive measures." Strategies included ensuring nurses proficiently assess LLL following gynecologic malignancy surgeries, enhancing standardized preventive measures for LLL post-GOS, and establishing personalized and diversified education models. Following the implementation of QCC activity, there was a significant improvement in the compliance rate of LLL prevention care measures. The compliance rate increased from 74.00% before the activity to 92.80%, surpassing the target rate by 119.00%, with an improvement rate of 25.40%. Comprehensive evaluations of circle members' abilities showed significant improvement, with notable increases in problem-solving abilities, initiative, and confidence.
Implementation of QCC activity resulted in a substantial improvement in compliance with LLL prevention care measures following GOS, ensuring safer and more effective patient care services.
本研究旨在通过品管圈（QCC）活动提高妇科肿瘤手术后下肢淋巴水肿（LLL）预防护理措施的依从性，以改善患者康复结局并减少术后并发症。
在医院内开展为期6个月的QCC活动，采用QCC活动的十步骤计划-执行-检查-行动模式。分析LLL预防护理措施实施不足的根本原因，从而制定相关策略和方案。比较QCC活动前后预防护理措施的依从率。
本次改进举措的重点是“术后预防措施不足”和“缺乏标准化出院预防措施”。策略包括确保护士在妇科恶性肿瘤手术后能熟练评估LLL，加强妇科肿瘤手术后LLL的标准化预防措施，以及建立个性化和多样化的教育模式。实施QCC活动后，LLL预防护理措施的依从率有显著提高。依从率从活动前的74.00%提高到92.80%，超过目标率119.00%，改进率为25.40%。对圈员能力的综合评估显示有显著提升，解决问题的能力、主动性和自信心均有明显提高。
实施QCC活动使妇科肿瘤手术后LLL预防护理措施的依从性有显著提高，确保了更安全、有效的患者护理服务。
