[1]屈晓玲王颖杨婷周雁荣.降低泌尿系统疾病患者围术期VTE发生率[J].中国卫生质量管理,2021,28(08):062-67.[doi:10.13912/j.cnki.chqm.2021.28.8.17 ]
 QU Xiaoling,WANG Ying,YANG Ting.Reducing the Incidence of Perioperative VTE in Patients with Urinary System Diseases[J].Chinese Health Quality Management,2021,28(08):062-67.[doi:10.13912/j.cnki.chqm.2021.28.8.17 ]
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降低泌尿系统疾病患者围术期VTE发生率
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年08期
页码:
062-67
栏目:
QC小组平台
出版日期:
2021-08-28

文章信息/Info

Title:
Reducing the Incidence of Perioperative VTE in Patients with Urinary System Diseases
作者:
屈晓玲王颖杨婷周雁荣
华中科技大学同济医学院附属同济医院
Author(s):
QU XiaolingWANG YingYANG Ting
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
关键词:
品管圈问题解决型品管圈泌尿系统疾病围术期静脉血栓栓塞症发生率
Keywords:
Quality Control Circles Problem Solving Quality Control Circle Urinary System Diseases Perioperative Venous Thrombosis Embolism Incidence
分类号:
R197.323;R69
DOI:
10.13912/j.cnki.chqm.2021.28.8.17
文献标志码:
B
摘要:
成立品管圈小组,通过现况把握、原因解析、对策拟定,制定SMOOTH干预模式,包括:S(Staff)-人员,推动多学科合作,共谋血栓防控;M(Method)-方法,基于循证证据,规范标准流程;O(Operate)-实施,强化专项改善,实施精准预防;O(On time feedback)-反馈,实时质控反馈,科学有效预防;T(Train)-培训,全民培训宣教,强化防控意识;H(Health information system) -信息系统,构建信息平台,助力血栓防治。实施后泌尿系统疾病患者围术期VTE发生率由2.81%下降至1.12%,促进了VTE多学科团队合作,提高了医疗质量和护理质量,保障了患者安全。
Abstract:
A quality control circle team was established. Through understanding the current situation,analyzing the causes and formulating countermeasures, the SMOOTH intervention mode was developed, including S (Staff) for personnel, to promote multidisciplinary cooperation and conspire thrombus prevention and control; M for Method, based on evidence-based evidence, to standardize the standard process; O for Operation, strengthen special improvement, implement precise prevention; O for on time feedback, real-time quality control feedback, scientific and effective prevention; T for training, public training and education, strengthening prevention and control awareness; H for Health Information System, building an information platform to help prevent and cure thrombosis. After the implementation, the incidence of perioperative VTE in patients with urinary system diseases decreased from 2.81% to 1.12%, which promoted the multidisciplinary teamwork of VTE, improved the quality of medical and nursing, and ensured the safety of patients.

参考文献/References:

[1]中华医学会外科学分会血管外科图5优化后泌尿系统疾病患者围术期VTE预防作业流程 表2 活动检讨与改进 活动步骤 优点 缺点及努力方向主题选定 以患者围术期安全及质量为中心,结合实际,重点解决临床共性及突出问题 为泌尿外科手术患者提供更优质服务计划拟定 有计划性、目的性,责任明确 使圈员对整个活动计划有整体概念现况把握 收集数据,了解泌尿系统疾病患者围术期VTE发生率及管理薄弱环节,明确改进方向 收集数据时对工作量预估不足,圈员工作负荷较重目标设定 根据病房实际及圈员能力,合理设定目标 可考虑在总体目标框架下,将目标进行分解解析 医、护、技、管、信团结协作,深入剖析 可尝试对患者进行访谈,深入了解其预防VTE态度及行为动机对策拟定 基于循证证据和专家经验,结合临床实际,使每条对策具有针对性和可操作性 进一步处理好最佳证据与临床实际及患者意愿之间的关系对策实施与检讨 对于选定对策,圈员能够积极配合,具有较强的执行力 对策实施需形成长效机制,确保效果维持标准化 制定了系列标准化流程及工作指引,完善了科室督查制度 加强人员培训,严格按流程和工作指引执行,达到同质化;注意与时俱进,及时修订学组.深静脉血栓形成的诊断和治疗指南(第三版)[J].中华普通外科杂志,2017,32(9): 807-812. [2]王培红,李素云,桂慧华,等.新编围术期疼痛护理学[M].武汉:湖北科学技术出版社, 2013:98-101. [3]田 华,宋 越.截石位相关深静脉血栓形成风险因素分级预防的临床观察[J].中国医刊,2019,54(10):1149-1152. [4]王玉梅,马爱玲,张 莉,等.泌尿外科术后深静脉血栓形成的相关危险因素[J].国际护理学杂志,2019,38(18):3053-3056. [5]Mcalpine K, Breau RH, Mallick R, et al. Current guidelines do not sufficiently discriminate venous thromboembolism risk in urology[J].Urologic Oncology, 2017,35(7):457.e1-457.e8. [6]Saluja M, Gilling P. Venous thromboembolism prophylaxis in urology: a review[J].International Journal of Urology, 2017, 24(8): 589-593. [7]Guyatt GH, Eikelboom JW, Gould MK, et al. Approach to outcome measurement in the prevention of thrombosis in surgical and medical patients: antithrombotic therapy and prevention of thrombosis: american college of chest physicians evidence-based clinical practice guidelines[J].Chest, 2012, 141(2): e185S-e194S. [8]Doiron RC,Booth CM,Wei X,et al. Risk factors and timing of venous thromboembolism after radical cystectomy in routine clinical practice: a population -based study[J].BJU International,2016,118(5): 714-722. [9]Forrest JB,Clemens JQ,Finamore P,et al.AUA best practice statement for the prevention of deep vein thrombosis in patients undergoing urologic surgery[J].The Journal of Urology,2009,181(3):1170-1177. [10]Tikken K,Cartwright R,Guyatt G,et al.EAU guideline on thromboprophylaxis in urological Surgery[EB/OL].(2020-10-28).http://uroweb.org/guideline/thromboprophylaxis. [11]柏杨,陈锦,黄鹂,等.缩短急性缺血性脑卒中患者DRT时间[J].中国卫生质量管理,2020,27(4):109-113.

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更新日期/Last Update: 2021-08-28