李紅花　吳秋婷

[摘要] 目的 探究在維持性血透患者中實(shí)施PDCA循環(huán)管理模式的應(yīng)用效果，以期為臨床維持性血液透析患者提供更好的護(hù)理服務(wù)，進(jìn)而降低高鉀血癥發(fā)生率。方法 收治數(shù)名維持性血透患者，詢問患者意見后選取124例納入研究，對照組62例實(shí)施常規(guī)化管理，觀察組實(shí)行PDCA循環(huán)管理模式，病例選取范圍：2017年3月—2019年7月，對比兩組護(hù)理結(jié)局。結(jié)果 兩組健康知曉率相比，觀察組飲食、遵醫(yī)囑及內(nèi)瘺保護(hù)及血壓達(dá)標(biāo)率均較高，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組高鉀血癥發(fā)生率相比，觀察組發(fā)生率更低，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組服務(wù)態(tài)度、穿刺技術(shù)、飲食及用藥指導(dǎo)、健康教育全面性評分相比，觀察組評分較高，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 在維持性血透患者中實(shí)施PDCA循環(huán)管理模式，能有效提升患者健康知識知曉率，降低高鉀血癥發(fā)生率，改善患者護(hù)理體驗(yàn)。

[關(guān)鍵詞] 維持性血透;PDCA循環(huán)管理;高鉀血癥;健康教育

[中圖分類號] R7 [文獻(xiàn)標(biāo)識碼] A [文章編號] 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(zhì)量管理是PDCA循環(huán)管理模式的基礎(chǔ)，與其相比PDCA管理對細(xì)節(jié)、護(hù)理過程等更加關(guān)注，計(jì)劃（P）、實(shí)施（D）、檢查（C）與處理（A）是PDCA循環(huán)管理模式的幾大環(huán)節(jié)[1]。鑒于此管理模式的全面性及科學(xué)性，近年來很多醫(yī)院都實(shí)行PDCA循環(huán)管理，尤其是在血液透析室中使用此管理模式后效果顯著[2]。血液透析目前主要用于終末期腎病的代替治療，患者血液經(jīng)導(dǎo)管被引流到體外，全部流入由無數(shù)根空心纖維組成的透析器中，血液與含機(jī)體濃度相似的電解質(zhì)溶液在一根根空心纖維內(nèi)外，通過彌散、超濾、吸附和對流原理進(jìn)行物質(zhì)交換，清除體內(nèi)的代謝廢物、維持電解質(zhì)和酸堿平衡;同時清除體內(nèi)過多的水分，并將經(jīng)過凈化的血液回輸?shù)恼麄€過程稱為血液透析。透析室工作專業(yè)性強(qiáng)、風(fēng)險大，涉及的知識面相當(dāng)廣泛，將PDCA循環(huán)管理模式運(yùn)用在血透室中能兼顧各方面護(hù)理工作，便于護(hù)士即時掌握患者情況，進(jìn)而實(shí)施針對性護(hù)理[3]。該研究重點(diǎn)探討此管理模式效果，現(xiàn)報道如下。