摘要
目的构建自体动静脉内瘘(AVF)全程链式管理模式。方法按照课题研究型品管圈活动步骤开展活动,通过现状水平分析、攻坚点挖掘、方策拟订,从组建MDT团队、建立居家管理模式、构建分级多维风险管理体系、实施家院全程照护等方面进行改进。结果AVF成熟不良率从17%降低至8.6%;AVF长期通畅率从75%提高至84.6%;AVF一次穿刺成功率从92.4%提升至99.2%;患者动静脉内瘘维护知识知晓度从25.9分提升至39.12分;动静脉内瘘绳梯式穿刺落实率从92.5%提升至100%;AVF远期并发症发生率从34.6%降低至18.6%。结论通过开展品管圈活动构建了AVF全程链式管理模式,延长了AVF使用寿命,降低了并发症发生率,提高了血液透析质量。
Objective To establish a comprehensive chain management model for autogenous arteriovenous fistula(AVF).Methods Quality Control Circle(QCC)activities were conducted following the steps of a research-oriented QCC project.Improvements were made through analyzing the current status,identifying key challenges,and formulating strategies,which included establishing a multidisciplinary team,developing a home-based management model,constructing a hierarchical and multi-dimensional risk management system,and implementing comprehensive homehospital care.Results The rate of immature AVF decreased from 17%to 8.6%;the long-term patency rate of AVF increased from 75%to 84.6%;the success rate of the first puncture for AVF improved from 92.4%to 99.2%;patients'awareness of AVF maintenance knowledge increased from 25.9 points to 39.12 points;the implementation rate of the rope-ladder puncture technique for AVF increased from 92.5%to 100%;and the incidence of long-term complications of AVF decreased from 34.6%to 18.6%.Conclusion By conducting QCC activities,a comprehensive chain management model for AVF was established,which prolonged the service life of AVF,reduced the incidence of complications,and improved the quality of hemodialysis.
作者
李芳
夏莎
杨锦涛
党聪蕊
王思佳
刘聪
冯晶
LI Fang;XIA Sha;YANG Jintao(The 986th Hospital of the Air Force,Xi'an,Shaanxi,710054,China)
出处
《中国卫生质量管理》
2025年第8期94-102,共9页
Chinese Health Quality Management
关键词
品管圈
课题研究型品管圈
自体动静脉内瘘
全程链式管理
血液透析
护理质量
Quality Control Circle
Research-Oriented Quality Control Circle
Autogenous Arteriovenous Fistula
Comprehensive Chain Management
Hemodialysis
Nursing Quality
