Quality Control Circle On Effects Of Dietary Adherence In Liver Cirrhosis Patients

Objectives Quality Control Circle was implemented in liver cirrhosis patients to evaluate the status of dietary adherence and analyze the reasons for poor adherence. Then implement targeted measures and compare diet adherence, complications presence and satisfaction differences before and after activities.Thus to assess effects of quality control tool on proving the diet compliance and provide scientific proof for its applying in clinic for the nursing quality consistently improving.Methods Convenience sampling was used. From February to June in2013, a total of152liver cirrhosis patients in thoracic surgery from one class A tertiary hospital of Shandong province were extracted as control group, while a total of161cirrhosis patients in the same department from August to December in2013were extracted as observation group. The control group received routine dietary care, while continuous quality improvement was implemented in the patients of observation group. Quality control circle group was established, from perspectives of nursing, patients and management, we summarized the reasons for poor adherence in cirrhosis patients through the brainstorming method, then presented the reasons by fishbone diagram and perceived them as the entry and key points of continuous quality improvement.Take appropriate measures against existing problems, according to different characteristics of patients, we develop personalized diet health education program through mutual collaboration of members, improve dietary management and health education materials and then tackled adverse factors affecting dietary adherence in patients with cirrhosis. Questionnaires on general information, dietary adherence and patient satisfaction scale were used to investigate the patients, and then compared diet adherence, complications presence and satisfaction differences in two group patients in two groups patients. SPSS17.0statistical software was used for data entry and analysis, including descriptive analysis, t-test, chi-square test and rank-sum test.Results A total of313patients were involved in this study, among them,152cases were extracted as control group,161cases were extracted as observation group. There were no statistical differences in gender, age, marital status, education, occupation, income and other general informations of two groups. Detailed informations were follows:1.In the control group, diet adherence of63cases(41.45%) was high,49cases(32.24%),40cases(26.31%) was moderate and low respectively. After the implementation of QCC, dietary adherence level of patients in the observation group was markedly improved t (P<0.01). Diet adherence of94cases (58.39%),48patients (29.81%),19cases (11.80%) was high, moderate and low respectively.2. Complications occurred in8cases in the control group, with4cases of gastrointestinal bleeding,2cases of hepatic encephalopathy and2cases of electrolyte imbalance. While there were2cases occurred in complications in the observation group, with1cases of gastrointestinal bleeding and1case of hepatic encephalopathy. The incidence of complications of two groups were significantly different (P<0.05).3. Total satisfaction of the control group was91.45%, including satisfaction of139cases,10cases of general satisfaction and3cases of dissatisfaction.Total satisfaction of the control group was96.89%, including satisfaction of156cases,5cases of general satisfaction. QCC activities effectively improve patient satisfaction (P<0.05).Conclusions QCC quality management tools application in cirrhosis patients can improve diet adherence, reduce patient complications and promote recovery, and then improve nursing satisfaction. Circle members work ethic, personal skills, creative thinking, teamwork techniques had also significantly improved in QCC activities, it’s worthy of further promotion.