——鲁文菊 惠蓉 袁雪 刘玲娇

【摘要】运用品管圈方法，组建多学科协作小组，针对提高围手术期使用胰岛素泵治疗糖尿病患者血糖控制达标率进行改进，包括完善资料、修订流程、落实培训与考核等。改善后，胰岛素泵操作规范率由32.7%提升至96.0%，非内分泌科胰岛素泵资料完善率由30.2%提升至95.0%，胰岛素泵操作正确率由35.0%提升至83.0%，患者及家属糖尿病知识知晓率由35.0%提升至83.0%，护士对专科知识知晓率由51.8%提升至96.0%，围手术期血糖控制达标率由45.0% 提升至76.5%。品管圈活动开展可有效提高糖尿病住院患者围手术期血糖控制达标率，使全院围手术期糖尿病患者胰岛素泵治疗血糖护理标准同质化，提高了患者满意度。

【关键词】 品管圈；问题解决型品管圈；糖尿病；围手术期；血糖控制

中图分类号：R197.323;R587.1文献标识码：B

Improve the Standard Rate of Blood Glucose Control in Patients with Diabetes Mellitus During Perioperative Period/LU Wenju,XI Rong,YUAN Xue,et al.//Chinese Health Quality Management，2021,28(12):71-75

Abstract Using the quality control circle, a multidisciplinary team was established to improve the blood glucose control standard rate in patients with diabetes treated with insulin pump during perioperative period,including the improvement of data, revision process, implementation of training and assessment.After improvement, the standard operation rate of insulin pump increased from 32.7% to 96.0%, and the data perfection of non-endocrinology insulin pump increased from 30.2% to 95.0%. The operation accuracy of insulin pump increased from 35.0% to 83.0%. The diabetes knowledge awareness rate of patients and their families increased from 35.0% to 83.0%; the specialized knowledge awareness rate of nurses increased from 51.8% to 96.0%; perioperative glucose control standard rate was increased from 45.0% to 76.5%. Quality control circle activities can effectively improve the compliance rate of perioperative blood glucose control in inpatients with diabetes, homogenize the nursing standard of perioperative blood glucose treatment with insulin pump in the whole hospital, and improve patient satisfaction.

Key words Quality Control Circle; Problem Solving Type Quality Control Circle; Diabetes; Perioperative Period; Blood Glucose Control

First-author's address Shaanxi Provincial People's Hospital, Xi 'an, Shaanxi, 710068,China

1主题选定

全体圈员通过头脑风暴法、民主投票法、圈外参与机制法［1］，立足临床实际，以问题为导向，列出临床工作中的突出问题，采用权重法和“5-3-1”评价法进行主题选定，最终选定得分最高的“提高糖尿病住院患者围手术期血糖控制达标率”为本期活动主题。经QC-Story判定，本期活动主题为问题解决型。

名词定义：（1）围手术期指从确定手术治疗时起，至与这次手术有关的治疗基本结束为止的一段时间［2］。它包括术前、术中、术后三个阶段。（2）血糖管理指通过糖尿病专科护士主导的多学科诊疗团队对糖尿病患者进行教育，从饮食治疗、运动锻炼、药物治疗、自我监测、健康教育和心理疏导6方面以及利用胰岛素泵治疗和护理措施，安全、平稳地降糖、降压、调脂和改变不良生活习惯，从而对血糖进行控制和治疗的活动［3］。（3）血糖控制达标率指糖尿病患者血糖管理达到控制目标的人数占糖尿病总人数的百分比［4］。

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