2017 年第 10 期 第 12 卷

应用品管圈对肠镜检查前口服聚乙二醇电解质散剂住院患者肠道清洁度合格率的影响

Effect of quality control circle on intestinal cleanliness qualified rate of polyethylene glycol electrolyte powder for colonoscopy in hospitalized patients

作者：杨军李井娜段爱丽乔佳高峰张杰

英文作者：Yang Jun Li Jingna Duan Aili Qiao Jia Gao Feng Zhang Jie

单位：100029首都医科大学附属北京安贞医院消化内科

英文单位：Department of Gastroenterology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：肠镜检查；品管圈；肠道清洁度；聚乙二醇电解质散剂

英文关键词：Enteroscopy；Qualitycontrolcircle；Intestinalcleanliness；Polyethyleneglycolelectrolytepowder

• 摘要：

• 目的 探讨应用品管圈对肠镜检查前口服聚乙二醇电解质散剂（舒泰清）住院患者肠道清洁度合格率的影响，从而探索出肠镜检查肠道准备更科学的方法。方法 选取首都医科大学附属北京安贞医院2016年3月至2017年2月需要做肠镜检查的住院患者776例作为研究对象，将2016年3—9月调查的480例患者设为活动前组，将2016年10月至2017年2月调查的296例患者设为活动后组。成立品管圈小组，以“提高住院患者肠镜检查前口服舒泰清药物肠道准备清洁度合格率”为活动主题，通过现状调查，设定目标值，解析出影响患者肠道准备清洁度的主要因素为：患者对清肠药物舒泰清饮水量大不耐受、护士宣教形式单一和护士无法评估患者肠镜检查前3 d饮食，故针对这3个真因来拟定对策并组织实施改进方案。比较活动前后肠道清洁度合格率，计算品管圈活动后的目标达成率和进步率，评估品管圈活动对圈员综合能力的影响。结果 活动后组肠道清洁度合格率明显高于活动前组［95.6％（283/296）比87.1％（418/480）］，差异有统计学意义(P＜0.001)。品管圈活动后的目标达成率为93.4％，进步率为65.9％。品管圈活动后，圈员对品管圈手法的认知和沟通协调、脑力激荡、团队精神、发掘问题的能力均有成长。结论 本次品管圈活动制定了肠道准备的宣传手册和宣传展板，规范了预约肠镜的流程，提高了患者肠道准备清洁度合格率，提升了护理人员的专业知识水平、团队协作精神及质量管理能力。

• Objective To investigate the effect of quality control circle（QCC） on intestinal cleanliness qualified rate of polyethylene glycol electrolyte powder（Shutaiqing） for colonoscopy in hospitalized patients. Methods Totally 776 hospitalized patients undergoing enteroscopy were enrolled from March 2016 to February 2017 in Beijing Anzhen Hospital, Capital Medical University; 480 patients who were investigated from March to September 2016 were pre-activity group; 296 patients who were investigated from October 2016 to February 2017 were post-activity group. QCC was established in order to improve the intestinal cleanliness qualified rate of oral taking Shutaiqing for enteroscopy; 3 main influence factors of intestinal cleanliness were resolved-patients intolerance of large volume of water intake, simple nursing education and incorrect assess of 3 d pre-enteroscopy diet; countermeasures and plans were developed. The intestinal cleanliness qualified rate before and after QCC activity, target achievement rate and progress rate were analyzed. The impact of QCC on comprehensive abilities of circle members was evaluated. Results The intestinal cleanliness qualified rate in post-activity group was significantly lower than that in pre-activity group［95.6％（283/296） vs 87.1％（418/480）］（P＜0.001）. The target achievement rate was 93.4% and the progress rate was 65.9%. Abilities of communication, coordination, brainstorming, team spirit and questions discovery of circle members were improved after QCC activity. Conclusion Application of QCC helps regulate standardized progress of enteroscopy, improve intestinal cleanliness qualified rate in hospitalized patients, and promote professional knowledge, teamwork spirit and quality management ability of nurses.