Abstract:

Objective　To explore the effect of fishbone diagram analysis combined with PDCA in improving the nurses' ability to prevent the pressure injury. Methods　This study was a quasi-experimental study. A total of 31 nurses were selected as the research subjects from Heyuan Hospital of Guangdong Provincial People's Hospital in December 2021, with working life of 4-30 years, aged (31.32±7.27) years. Since January 2022, we analyzed the factors that affected nurses' pressure injury risk assessment ability by drawing a fishbone diagram. Then we carried out the PDCA activities: (1)defining the work responsibilities and assessment system of the members of the specialist team; (2)refining the workflow to enhance the high-risk assessment of pressure injury; (3)developing pictorial health education manual and video for pressure injury prevention. The scores of nurses' pressure injury related knowledge and the implementation rate of pressure injury prevention measures for high-risk patients were compared before the implementation (December 2021) and after the implementation (June 2022). Paired t test and χ² test were used for statistical analysis. Results　After the implementation of PDCA activities, the score of nurses' stress injury related knowledge examination was higher than that before the implementation [(87.27±15.53) points vs. (60.45±8.18) points], and the implementation rate of pressure injury prevention measures for high-risk patients was higher than that before the implementation [88.83% (152/172) vs. 77.69% (101/130)], with statistically significant differences (t=-8.74, P=0.02; χ²=6.21, P=0.01). Conclusion　Fishbone diagram analysis and PDCA can improve the nurses' ability to prevent the pressure injury.

Key words:

PDCA cycle, Fishbone diagram, Pressure injury, Nurses

摘要：

目的　探讨PDCA循环法联合鱼骨图分析提升护士压力性损伤风险预防能力的效果。方法　本研究为类试验性研究。2021年12月选取广东省人民医院河源医院31名护士作为研究对象，工作年限4～30年，年龄（31.32±7.27）岁。于2022年1月起通过绘制鱼骨图分析影响护士压力性损伤风险评估能力的因素，并开展PDCA活动：明确专科小组成员的工作职责、考核制度，完善工作流程及压力性损伤风险管理制度，制定压力性损伤预防健康宣教图文手册以及宣教视频。采取自身前后对照，比较2021年12月（实施前）与2022年6月（实施后）护士压力性损伤相关知识考核得分、压力性损伤高风险预防措施落实率。统计学方法采用配对t检验、χ²检验。结果　实施PDCA活动后，护士压力性损伤相关知识考核得分高于实施前［（87.27±15.53）分比（60.45±8.18）分］，压力性损伤预防措施落实率高于实施前［88.83%（152/172）比77.69%（101/130）］，差异均有统计学意义（t=-8.74，P=0.02；χ²=6.21，P=0.01）。结论　PDCA循环联合鱼骨图分析能有效提升护士压力性损伤风险预防能力。

关键词:

PDCA循环, 鱼骨图, 压力性损伤, 护士