The Application Of The Process Management In Paclitaxel Chemotherapy

ObjectiveBy applying scientific methods of process management in paclitaxel chemotherapy, to reduce medication error, decrease adverse reaction and ensure patient safety. On this basis, by improving the development of process management in all aspects of nursing safety management in order to further standardizing the clinical nursing work.MethodsIn this research,137patients who conform to the requirement of paclitaxel preventive chemotherapy are selected. Among them,63patients who were not applied process management from April2009to October2010make up the control group; other75patients who carried out process management from November2011to March2012consist of experimental group. All the patients are in accordance with the conventional gynecologic chemotherapy nursing and applied symptomatic and supportive treatment according to the illness. On the basis of general treatment and routine nursing, the experimental group is strictly accordance with paclitaxel chemotherapy process during the procedure of using paclitaxel medication. At the same time, the control group takes the general gynecologic chemotherapy routine nursing. Both of the two groups make the comparison of adverse reaction rate, satisfaction rate, coverage rate and awareness rate of health education and so on.Research tools adopt questionnaire about satisfaction, questionnaire about health education and statistics table of allergic reaction.Use SPSS13.0statistic software to process the data, x2Test, orderly data rank-sum Test, t Test are applied, respectively, to compare the disorderly date before and after process management, the difference of order date and quantitative date.Results1. Process management compared to the situation before and after the occurrence of allergic reactions:, According to a research on75cases of paclitaxel chemotherapy patients after the implementation of process management, there has allergic reaction in5cases, including red face in3cases and urticaria in1case, Compared with control group, the incidence of red face and incidence of urticaria differences are statistically significant; Angioedema in1case, difficulty breathing or shock0cases, compared with the control group, the incidence of angioedema and difficulty breathing or shock incidence of no statistically significant difference.2. The comparison between medication error before and after process management:after process management, one medication error was found among75paclitaxel chemotherapy patients. The difference comparison with control group is statistically significant.3. Process management compared to the situation before and after the Satisfaction survey. After the implementation of process management,75cases of paclitaxel chemotherapy patients were conducted a satisfaction survey, which are comparatively satisfied with60people, satisfied with13people, not satisfied with2people. Use level data of rank and inspection Compared with the control group difference was statistically significant.(u=2.396,, P<0.05). The nurse satisfaction questionnaire including89satisfactions, six people were satisfactory, dissatisfied with1person, Compared with the control group difference was statistically significant.(u=4.984,, p<0.01). In total of46the doctor on job satisfaction of nurse questionnaire, including45satisfactions, comparatively satisfied with1person, not satisfied with0people. Compared with the control group, the difference was statistically significant (u=2.373, p<0.01). After the implementation of process management, the hospital customer service department did a revisit investigation. The number of complaints is only1, in addition,11people praise and13received testimonials. Compared with the control group, the difference was statistically significant.4. The comparison between the coverage rate and awareness rate of health education before and after process management:after the process management, a survey of coverage rate of health education of75patients who did chemotherapy is made. Among these75patients, the coverage rate of disease related knowledge is100%, the rate of diet activities knowledge is93.33%. The difference comparison with control group is statistically significant, as shown in the table4-7. In the survey of awareness rate of health education of75patients, the awareness rate of disease related knowledge is94.76%, the awareness rate of diet activities is97.33%, the awareness rate of medication knowledge is96%and the risk awareness rate is96%. The difference comparison with control group is statistically significant.5. The comparison between the nursing quality before and after the process management:after process management, comparison between individual nursing qualities is made. The score of basic nursing quality is95, nursing document is98, grading nursing is97and inpatient area management is97. The difference comparison with control group is statistically significant, as shown in the table4-9.The comparison between the qualities of night ward round by head nurse after process management, inpatient area management is99, work requirement is99.17, nursing quality is97.92and inpatient area safety is99. The difference comparison with control group is statistically significant.Conclusion1. Process management makes the use procedure of chemotherapy refining and professionalization. Carry out the nursing measures in a planned way can improve patient satisfaction, nursing staff satisfaction and satisfaction of doctors for nurses.2. Process management reduces medication error, delay medication, the rate of adverse nursing event and ensures patients safety. 3. Process management obviously improves coverage rate of health education and awareness rate of health education..