摘要：目的 ?探討FOCUS-PDCA程序在降低會陰側(cè)切率中的應(yīng)用效果。方法 ?將我院2017年1月～10月運用FOCUS-PDCA程序管理前經(jīng)陰道分娩的產(chǎn)婦2525例設(shè)為對照組，將2018年1月～10月運用FOCUS-PDCA程序管理后經(jīng)陰道分娩的產(chǎn)婦1974例設(shè)為觀察組，比較兩組會陰側(cè)率、會陰Ⅲ裂傷發(fā)生率、新生兒窒息發(fā)生率以及護理人員自評綜合能力。結(jié)果 ?觀察組會陰側(cè)切率（12.66%）低于對照組（25.03%），差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組會陰Ⅲ裂傷發(fā)生率（0）及新生兒窒息發(fā)生率（0.05%）低于對照組的0.04%、0.08%，但兩組比較差異均無統(tǒng)計學(xué)意義（P>0.05）;觀察組護理人員自評綜合能力各項評分均高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 ?運用FOCUS-PDCA程序后，雖然產(chǎn)婦會陰Ⅲ裂傷發(fā)生率、新生兒窒息發(fā)生率無明顯下降，但是該程序的運用降低了產(chǎn)婦陰道分娩會陰側(cè)切率，且可以有效提高護理人員的綜合能力，有利于臨床產(chǎn)科護理質(zhì)量持續(xù)優(yōu)化。

關(guān)鍵詞：FOCUS-PDCA程序;產(chǎn)婦;會陰側(cè)切;會陰裂傷

中圖分類號：R473.71 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2018.24.045

文章編號：11006-1959（2018）24-0151-03

Abstract：Objective ?To explore the application effect of FOCUS-PDCA procedure in reducing the rate of perineal cut. Methods ?The 2525 cases of vaginal delivery before the administration of FOCUS-PDCA program in our hospital from January to October 2017 were used as the control group. The women who were vaginally delivered after the FOCUS-PDCA procedure were administered from January to October 2018. 1974 cases were set as observation group， and the rate of perineal side， perineal III laceration， the incidence of neonatal asphyxia and the comprehensive ability of self-evaluation of nursing staff were compared between the two groups. Results ?The perineal cut rate （12.66%） in the observation group was lower than that in the control group （25.03%）， the difference was statistically significant （P<0.05）. The incidence of perineal III laceration in the observation group （0） and the incidence of neonatal asphyxia （0.05%）was lower than 0.04% and 0.08% of the control group， but there was no significant difference between the two groups （P>0.05）. The scores of the self-evaluation comprehensive ability of the nursing staff in the observation group were higher than the control group，the difference was statistically significant（P<0.05）. Conclusion ?After the FOCUS-PDCA procedure， although the incidence of maternal perineal III laceration and the incidence of neonatal asphyxia did not decrease significantly， the application of this procedure reduced the rate of perineal cut in the vaginal delivery of the mother， and can effectively improve the comprehensive ability of the nursing staff. Conducive to the continuous optimization of clinical maternity care quality.

Key words：FOCUS-PDCA procedure;Maternal;Perineal lateral incision;Perineal laceration

FOCUS-PDCA程序在降低會陰側(cè)切率中的應(yīng)用

芮青美

（南京市高淳縣人民醫(yī)院婦產(chǎn)科，江蘇 ?南京 ?211300）

摘要：目的 ?探討FOCUS-PDCA程序在降低會陰側(cè)切率中的應(yīng)用效果。方法 ?將我院2017年1月～10月運用FOCUS-PDCA程序管理前經(jīng)陰道分娩的產(chǎn)婦2525例設(shè)為對照組，將2018年1月～10月運用FOCUS-PDCA程序管理后經(jīng)陰道分娩的產(chǎn)婦1974例設(shè)為觀察組，比較兩組會陰側(cè)率、會陰Ⅲ裂傷發(fā)生率、新生兒窒息發(fā)生率以及護理人員自評綜合能力。結(jié)果 ?觀察組會陰側(cè)切率（12.66%）低于對照組（25.03%），差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組會陰Ⅲ裂傷發(fā)生率（0）及新生兒窒息發(fā)生率（0.05%）低于對照組的0.04%、0.08%，但兩組比較差異均無統(tǒng)計學(xué)意義（P>0.05）;觀察組護理人員自評綜合能力各項評分均高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 ?運用FOCUS-PDCA程序后，雖然產(chǎn)婦會陰Ⅲ裂傷發(fā)生率、新生兒窒息發(fā)生率無明顯下降，但是該程序的運用降低了產(chǎn)婦陰道分娩會陰側(cè)切率，且可以有效提高護理人員的綜合能力，有利于臨床產(chǎn)科護理質(zhì)量持續(xù)優(yōu)化。

關(guān)鍵詞：FOCUS-PDCA程序;產(chǎn)婦;會陰側(cè)切;會陰裂傷

中圖分類號：R473.71 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2018.24.045

文章編號：11006-1959（2018）24-0151-03

Application of FOCUS-PDCA Procedure in Reducing the Rate of Perineal Cut

RUI Qing-mei

（Department of Obstetrics and Gynecology，Gaochun County People's Hospital，Nanjing 211300， Jiangsu，China）

Abstract：Objective ?To explore the application effect of FOCUS-PDCA procedure in reducing the rate of perineal cut. Methods ?The 2525 cases of vaginal delivery before the administration of FOCUS-PDCA program in our hospital from January to October 2017 were used as the control group. The women who were vaginally delivered after the FOCUS-PDCA procedure were administered from January to October 2018. 1974 cases were set as observation group， and the rate of perineal side， perineal III laceration， the incidence of neonatal asphyxia and the comprehensive ability of self-evaluation of nursing staff were compared between the two groups. Results ?The perineal cut rate （12.66%） in the observation group was lower than that in the control group （25.03%）， the difference was statistically significant （P<0.05）. The incidence of perineal III laceration in the observation group （0） and the incidence of neonatal asphyxia （0.05%）was lower than 0.04% and 0.08% of the control group， but there was no significant difference between the two groups （P>0.05）. The scores of the self-evaluation comprehensive ability of the nursing staff in the observation group were higher than the control group，the difference was statistically significant（P<0.05）. Conclusion ?After the FOCUS-PDCA procedure， although the incidence of maternal perineal III laceration and the incidence of neonatal asphyxia did not decrease significantly， the application of this procedure reduced the rate of perineal cut in the vaginal delivery of the mother， and can effectively improve the comprehensive ability of the nursing staff. Conducive to the continuous optimization of clinical maternity care quality.

Key words：FOCUS-PDCA procedure;Maternal;Perineal lateral incision;Perineal laceration