| Emergency patients transport is an important part of hospital rescue and ahigh-risk area of emergency nursing.Though the process of patients transport andhandover is short, there are many risk factors life-threatening to severe patients anderror information which are critical to the treatment process. Patient safetymanagement is the principle work and critical to protect patient safety. It is the keyto reduce quality defects and improve care level, objective need to control oreradicate insecurity and avoid medical disputes or accidents.There are many severe patients in emergency department cooperated closelywith multisectoion. They need transport in hospital or frequent interdepartmentalhandover to have a definite diagnosis, surgery or hospitalization.So we have established a platform for third-party satisfaction survey.Through understanding patient transport satisfaction of the emergencydepartment by the ward nurses， communication and feedback were acquiredbetween emergency nurses and ward.There are many contradictions in emergencypatients transport and ward convergence process which have a bad influence on thedisposal of the next patient’s treatment, delaying the disease and seriously affectingthe quality of medical care in our hospital.QCC.（Quality Control Circle）refers to the team in the same unit or relatedpersons automaticly self-organized and use scientific management tools to improveefficiency, reduce costs and improve product quality continuely. The original issue（edited by Health Ministry "three grades general hospital accreditation standardsimplementing rules2011Edition)", which repeatedly referred to the use of qualitymanagement tools, through the process of formulating and implementating quality management program,is to achieve sustained health care quality and safetyimprovements.Therefore QCC-the quality management tools is proposed to takenin hospitals all around the country.It will coordinate the reform of public hospitalsand closely create high-quality hospital，promoting sustainable improvements ofhealth care quality and safety.Objective:Investigate transport and handover satisfaction of the ward nurses to emergencynurses and establish "quality circles" group.Through the implementation andapplication of quality management tools, identify the dissatisfaction factors inemergency transport and handover process,then make improvements to improve it’ssatisfaction and regulate behavior to protect patients safety and improve transportcare quality.Nurses participated in the use of quality control circle increase theirabilities in using management tools and team cooperation..Methods:Domestic and international databases such as National KnowledgeInfrastructure，NKI, VIP database, PubMed etc were widely consulted on to providea theoretical and methodological basis for this study.Consulting on Assessment Scale and review of relevant experts, a Questionnairedesigned to assess emergency transport satisfaction by ward nurses. It is prevalencesurvey stage from September to October2013. More clinical frontline nurses in eightdepartments (neurosurgery, neurology, ICU, CCU, gastroenterology, respiratorymedicine, general surgery, orthopedics) were selected in Siping centre hospital to fillout satisfaction surveys for the study.critical patients with Learning disharmoniousfactors in transport and handover process between emergency department nurses andward nurses in this stage， the proportion of each factor and cumulative percentage.Were calculated. By drawing Plato and " using the two-eight Law," the maindissatisfaction factors of emergency transport and handover were identified, causeanalysis were taken by the use of fishbone diagram. Appropriate measures weredeveloped and implemented. QCC survey questionnaires were given out again inJanuary and February,2014.The investigators are the same as the previous stage.Epidate3.0database are established, the double entry method are used in data entry.SPSS18.0are used for data processing. Appropriate statistical methods are used ondata types. Rank sum test is used, P <0.05was considered statistically significant difference.Results:1.180nurses participated in this research before and after the QCC.180questionnaires were given out twice, then recovery and efficient rate was100%.2. The study found that the main factors affecting the emergency transportsatisfaction were: supplemental test and a positive result does not accounted forclearly, poor catheter position in the bend, prepare time set aside for the ward nursesis not sufficient, catheter is removed or fixed inappropriately.3. After the implementation of quality control circle, the patient’s conditionwere nformed in detail by emergency nurses to ward nurses through telephoneduring transport process, outpatient laboratory examinations and related positiveresults were told, the patient’s disease known by assistant nurses etc.emergencytransport satisfaction assesment significantly better prior to the implementation ofquality control circles, the difference was statistically significant,(P <0.01).4. After the implementation of quality control circles, satisfaction rating ofmanagement for various unobstructed or properly fixed pipeline and cathetersituations in transport or handover process assessed by ward nurses for emergencynurses was significantly higher than before, the difference was statisticallysignificant,(P <0.01).5.After the implementation of quality control circle, satisfaction rating for thetransport and handover record writed clearly without alteration, the transport andhandover form filled out completely and accurately was significantly higher thanbefore by ward nurses for emergency nurses,the difference was statisticallysignificant,(P <0.01).6. Before QCC, satisfaction rate assessed by ward nurses for emergency nurseswas57.3%.After the conduct quality control circle, the satisfaction rate is78.21%which is higher than before. the difference was statistically significance,(P <0.05).Conclusion:After the study of the main factors affecting satisfaction of the ward nurses toemergency nurses are as follows:supplemental test result does not accounted for indetail. are not sufficient, prepare time set aside for the ward nurses is not sufficient,catheter is removed or fixed inappropriately.The study found that the use of QCC quality tools used in quality management of emergency transport and handover process, which can significantly improve thesatisfaction evaluation to emergency nurses.It can effectively reduce medicaldisputes, and ensure quality of care or harmonious sector cooperation.After implementation of quality control circles, overall satisfaction of wardnurses to emergency nurses satisfaction was significantly higher than before.Inaddition to the satisfaction rating improved significantly to emergencynurses’information and pipeline situation in the transport transport and handoverprocess. Preliminary disposal had no improvement and is the main factors caused inthe present stage. Management blind spots exist in the course of QCCimplementation. There are also measures not practically maken or not implementedappropriately resulting in unsatisfactory results and re-PDCA.Circulating PDCA isnecessary in the practical application of quality control circle.Implementation of QCC activity is to enhance the satisfaction of ward nurse toemergency nurse in handover or transport process.It ensures the care quality oftransport and protects the safety of patients transport. Meanwhile, theImplementation QCC activities, which stimulate assessing thinking of circlemembers and enhance the ability to use quality management tools, improved staffmotivation of work.Therefore QCC quality management tools should be used in clinical nursingmanagement application and promotion. |
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