Yuan Shan, Yu Bingjing, Song Lingyun, Chen Linping, Hong Fenfen
Division of Gastroenterology, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, People's Republic of China.
J Multidiscip Healthc. 2025 Sep 6;18:5621-5634. doi: 10.2147/JMDH.S524337. eCollection 2025.
This study aimed to reduce the incidence of hypoglycemia following endoscopic polypectomy by implementing Quality Control Circle (QCC) interventions.
Quality Control Circle (QCC) empowered clinicians to implement PDCA-driven protocol refinements, standardizing care processes to mitigate hypoglycemia risk. Establish a QCC team to investigate the current incidence of hypoglycemia in post-polypectomy patients, conduct a root cause analysis to identify the true causes, formulate corresponding countermeasures, and implement them in phases. The study was conducted in two phases: before-QCC (517 patients from March 13 to May 31, 2023) and after-QCC (1090 patients from June 1 to November 30, 2023). The primary outcome was the incidence of hypoglycemia.
Before QCC implementation, the incidence of hypoglycemia was 6.63%. Following the introduction of QCC interventions, the incidence significantly decreased to 2.94% (<0.01). Monthly data revealed a continuous decline in hypoglycemia incidence, with rates dropping from 4.12% in June to 1.47% in November, and the results are statistically significant (<0.001). Other confounding factors, including age, gender, education level, diabetes history, polyp size, site, and fasting duration, were not significantly associated with the outcome (>0.05).
This study effectively reduced the incidence of hypoglycemia in patients following endoscopic polypectomy through the implementation of QCC activities, significantly enhancing patient safety and treatment outcomes. The successful implementation of the project validated the important role of QCC in continuous quality improvement, providing valuable experience and methods for future clinical nursing management.
本研究旨在通过实施质量控制圈（QCC）干预措施降低内镜下息肉切除术后低血糖的发生率。
质量控制圈（QCC）使临床医生能够实施由计划-执行-检查-处理（PDCA）驱动的方案改进，规范护理流程以降低低血糖风险。成立QCC小组，调查息肉切除术后患者低血糖的当前发生率，进行根本原因分析以确定真正原因，制定相应对策并分阶段实施。本研究分两个阶段进行：QCC实施前（2023年3月13日至5月31日的517例患者）和QCC实施后（2023年6月1日至11月30日的1090例患者）。主要结局是低血糖的发生率。
在实施QCC之前，低血糖发生率为6.63%。引入QCC干预措施后，发生率显著降至2.94%（<0.01）。月度数据显示低血糖发生率持续下降，从6月的4.12%降至11月的1.47%，结果具有统计学意义（<0.001）。其他混杂因素，包括年龄、性别、教育水平、糖尿病史、息肉大小、部位和禁食时间，与结局无显著相关性（>0.05）。
本研究通过实施QCC活动有效降低了内镜下息肉切除术后患者低血糖的发生率，显著提高了患者安全性和治疗效果。该项目的成功实施验证了QCC在持续质量改进中的重要作用，为未来临床护理管理提供了宝贵的经验和方法。
