PDCA循环管理应用于维持性血透患者健康知识知晓率、高钾血症发生率的影响

李红花　吴秋婷

[摘要] 目的 探究在维持性血透患者中实施PDCA循环管理模式的应用效果，以期为临床维持性血液透析患者提供更好的护理服务，进而降低高钾血症发生率。方法 收治数名维持性血透患者，询问患者意见后选取124例纳入研究，对照组62例实施常规化管理，观察组实行PDCA循环管理模式，病例选取范围：2017年3月—2019年7月，对比两组护理结局。结果 两组健康知晓率相比，观察组饮食、遵医嘱及内瘘保护及血压达标率均较高，组间差异有统计学意义（P<0.05）;两组高钾血症发生率相比，观察组发生率更低，组间差异有统计学意义（P<0.05）。两组服务态度、穿刺技术、饮食及用药指导、健康教育全面性评分相比，观察组评分较高，组间差异有统计学意义（P<0.05）。结论 在维持性血透患者中实施PDCA循环管理模式，能有效提升患者健康知识知晓率，降低高钾血症发生率，改善患者护理体验。

[关键词] 维持性血透;PDCA循环管理;高钾血症;健康教育

[中图分类号] R7 [文献标识码] A [文章编号] 1672-5654（2020）05（c）-0074-03

Impact of PDCA Cycle Management on Health Knowledge Awareness Rate and Incidence of Hyperkalemia in Maintenance Hemodialysis Patients

LI Hong-hua， WU Qiu-ting

Department of Internal Medicine， the People's Hospital of Huaiji County， Huaiji， Guangdong Province， 526400 China

[Abstract] Objective To explore the application effect of the PDCA cycle management model in maintenance hemodialysis patients， in order to provide better nursing services for clinical maintenance hemodialysis patients， and then reduce the incidence of hyperkalemia. Methods Several maintenance hemodialysis patients were treated. 124 patients were selected for group study after asking their opinions. The control group was routinely administered. The observation group was implemented with PDCA cycle management mode. The range of cases was selected from March 2017 to July 2019. The nursing outcomes were compared between the two groups. Results Compared with the health awareness rate in the two groups， the observation group had higher rates of diet， medical advice， internal fistula protection， and blood pressure compliance， with significant differences between the groups（P<0.05）. The incidence was lower in the group， and the difference between the groups was statistically significant （P<0.05）. The observation group scored higher in-service attitude， puncture technique， diet and medication guidance， and health education comprehensive scores between the two groups， with statistically significant differences between the groups（P<0.05）. Conclusion The implementation of PDCA cycle management mode in maintenance hemodialysis patients can effectively improve the health knowledge awareness rate of patients， reduce the incidence of hyperkalemia， and improve the nursing experience of patients.

[Key words] Maintenance hemodialysis; PDCA cycle management; Hyperkalemia; Health education

全面質量管理是PDCA循环管理模式的基础，与其相比PDCA管理对细节、护理过程等更加关注，计划（P）、实施（D）、检查（C）与处理（A）是PDCA循环管理模式的几大环节[1]。鉴于此管理模式的全面性及科学性，近年来很多医院都实行PDCA循环管理，尤其是在血液透析室中使用此管理模式后效果显著[2]。血液透析目前主要用于终末期肾病的代替治疗，患者血液经导管被引流到体外，全部流入由无数根空心纤维组成的透析器中，血液与含机体浓度相似的电解质溶液在一根根空心纤维内外，通过弥散、超滤、吸附和对流原理进行物质交换，清除体内的代谢废物、维持电解质和酸碱平衡;同时清除体内过多的水分，并将经过净化的血液回输的整个过程称为血液透析。透析室工作专业性强、风险大，涉及的知识面相当广泛，将PDCA循环管理模式运用在血透室中能兼顾各方面护理工作，便于护士即时掌握患者情况，进而实施针对性护理[3]。该研究重点探讨此管理模式效果，现报道如下。