| ObjectiveTo explore the project achieving quality control circle in order to reduce the missing rate as the starting point to standardize the sputum specimens retention process,to further improve the quality of the sputum retainion in the result and understanding the activities of the nurses’critical thinking ability and related knowledge and skills influence,in order to promote the subject to achieve the application of type pipe in the hospital to provide a scientific basis.MethodsThis study is to improve the missed samples of sputum specimen from the respiratory intensive care unit of a top three hospital in Shenyang(the missing rate is reduced from 47.60%to 13.61%)through the problem-solving style tube,but the missing rate picks up during the effect keeping period(18.18%).The purpose of this research is to further improve the quality of sputum specimen by reaching the target market.First of all,the department focused on the theme of"to reduce the missing rate of sputum specimens,"and conducted a project based on the principle of substantially breaking the status quo and challenging the quality level of attractiveness.The circle was composed of 12 nurses.Secondly,to collect the sputum specimen data from July to August 2016 in the department,totaling 416 sputum samples and 82 missing samples,analyzing the main factors leading to missing samples,selecting key points for solving the problems,formulating solutions and implementing improvement measures.Proposed:to improve the collection time,chlorhexidine gluconate gargle,modified Venturi device active warming humidification oxygen supply device of airway humidification process,oropharyngeal airway intervention under vacuum suction sputum collection method,317 supporting WeChat public platform of health education improve patient and family compliance measures.In the period from November to December in 2016,there were 345 sputum samples and 27 missed samples,so as to clarify the effect of the improved sample tube to improve the missed sample detection of sputum samples.Before and after the activity,the patient’s sputum bacteriology diagnosis time,the missing rate of pathogenic bacteria,to explore quality control nurses workload and the impact on medical activities.Then,in order to clarify the subject to achieve the value of the product quality control loop in improving nurses’ability and cooperation in health care,using self-designed questionnaire,the judgment thinking ability of circle nurses and the knowledge of sputum specimens-attitude-behavioral abilities and doctor satisfaction with the sputum specimens taken from three aspects before and after the investigation.At the same time,using the Questionnaire of Quality Control Circle Activity Inventory to evaluate the activities,the paper put forward the improvement strategies for the problems found in the implementation of the product pipe circle,which will provide a reference for further popularizing the subject.Results1.Before and after the implementation of the project achieving quality control circle quality of the sputum retained:sputum detection rate decreased from 19.71%to7.82%,the difference was statistically significant(χ~2=21.710,P<0.05);There was no significant difference in the average daily working hours of nurses before and after QC activities(Z=0.091,P>0.05);the average time of bacteriologically confirmed 4days shortened to 3 days,the difference was statistically significant(Z=-12.242,P<0.001).The detection rate of pathogenic bacteria by 36.36%increased to 49.42%,and the difference was statistically significant(χ~2=5.642,P<0.05).2.Before and after the project achieving quality control circle quality nurses’critical thinking ability:circle by before there are 4 tendencies and critical thinking of serious opposition to the nurse,after the critical thinking Questionnaire total score are the critical thinking tendency is in the range of 210~280 fractional interval and contradiction,there was significant difference in the score of 7 dimensions,(Z=-3.089、-3.095、-3.076、-3.071、-3.077、-3.083、-3.169,P<0.05),showed that activity circle of critical thinking to enhance the overall.The sputum was collected knowledge-attitude-behavior ability in:The mastery of knowledge had the statistical significance in difference between the results(t=-2.843,P<0.05),it showed that the project achieving quality control circle quality can improve the nurses the ability of collectting sputum.3.Before and after the activity the satisfaction of sputum retained among doctors:sputum specimens from the doctors satisfaction questionnaire by average(4.73±1.68)points to(10.73±2.33)points,by rank sum test to the project achieving quality control circle quality before and after the 5 dimensions of the score,the results were statistically different(P<0.05).4.The difficult factors of the project achieving quality control circle quality:On personnel factors,the average score of the project achieving quality control circle quality members was(26.14±3.36);On the the project achieving quality control circle quality skills factors,the project achieving quality control circle quality members in data collection and collation of this time-consuming and data collection was not complete,has relatively low score,the average value(1.67±0.62)and(1.58±0.64).On the institutional factors,the average score of the project achieving quality control circle quality members was(24.38±2.23).ConclusionAfter the problem solving type of the project achieving quality control circle quality’s improvement,the project reached type of the project achieving quality control circle quality could further reduce the sputum detection rate,shorten the time of patients with bacteriologically confirmed,and increase the detection rate of pathogenic bacteria,improve the quality of the sputum retained,sputum specimens of doctors and improve job satisfaction,increase the nursing workload.Moreover,a type of the project achieving quality control circle quality activities can improve the nurse’s motivation,inspire the critical thinking ability of the nurses and enhance the nurses’knowledge of the sputum specimen. |
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