标题：PDCA管理在CT增强扫描患者造影剂外渗预防中的应用

      作者：刘志芳，卢艳君，张碧红    深圳市宝安区松岗街道松岗人民医院医学影像科，广东 深圳 518105

      卷次： 2019年30卷22期

      【摘要】 目的 探讨PDCA管理[即计划(Plan)、执行(Do)、检查(Check)、处理(Act)管理]在预防增强扫描患者造影剂外渗中的应用价值。方法 将2016年1月至2019年1月深圳市宝安区松岗街道松岗人民医院收治的90例拟行CT增强扫描患者根据随机数表法分为观察组和对照组各45例，观察组采用PDCA管理，对照组采用传统护理。比较两组患者的造影剂外渗发生率、外渗程度，以及检查过程中肢体移动、依从性、医疗纠纷发生率、对CT增强扫描认知、不良反应和对护理服务满意度。结果 观察组患者中有3例发生外渗，对照组有10例发生外渗，且观察组的外渗以轻中度为主，对照组以中重度为主，两组患者的造影剂外渗率比较，差异有统计学意义(P<0.05)；观察组和对照组患者检查过程中肢体移动率(2.22% vs 13.33%)、医疗纠纷发生率(0 vs 8.89%)、不良反应发生率(6.67% vs22.22%)比较，观察组明显低于对照组，差异均有统计学意义(P<0.05)；观察组和对照组患者的治疗依从率(88.89%vs 66.67%)、对CT增强扫描认知度评分[(12.62±2.75)分 vs (8.12±2.03)分]、护理服务满意率(91.11% vs 71.11%)比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)。结论 PDCA管理可提高患者CT增加扫描过程中依从性，减少造影剂外渗和不良反应发生率，提高护理服务质量。
      【关键词】 PDCA管理；CT增强扫描；造影剂外渗；预防；影像科；计算机体层成像
      【中图分类号】 R47 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2990—03

Application of PDCA management in prevention of contrast agent extravasation in patients undergoing enhancedCT scanning.
LIU Zhi-fang, LU Yan-jun, ZHANG Bi-hong. Medical Imaging Department, Songgang People's Hospital ofBaoan District of Shenzhen, Shenzhen 518105, Guangdong, CHINA
【Abstract】 Objective To explore the application value of PDCA (Plan, Do, Check, Act) management in pre-venting extravasation of contrast agent in enhanced scanning patients. Methods Ninety patients scheduled for en-hanced CT scanning in Songgang People's Hospital of Baoan District of Shenzhen from January 2016 to January 2019were divided into two groups according to random number table. The observation group (45 cases) was managed by PD-CA, and the control group (45 cases) was treated by traditional nursing. The difference of the incidence and degree of ex-travasation of contrast agent between the two groups was observed, and the differences of limb movement, compliance,incidence of medical disputes, CT enhanced scanning awareness, adverse reactions, and satisfaction with nursing servicewere compared between the two groups. Results There were 3 cases of extravasation in the observation group (mainlymild to moderate) and 10 cases in the control group (mainly moderate to severe), and there was a significant differencebetween the two groups in the incidence of extravasation (P<0.05). The incidence of limb movement (2.22% vs 13.33%),the incidence of medical disputes (0 vs 8.89%), and the incidence of adverse reactions (6.67% vs 22.22%) were signifi-cantly lower in the observation group than in the control group (P<0.05). Compliance rate, cognitive score of CT en-hanced scanning, and satisfaction rate of nursing service in the observation group were significantly higher than those inthe control group (P<0.05): 88.89% vs 66.67%; (12.62±2.75) vs (8.12±2.03); 91.11% vs 71.11%. Conclusion PDCAmanagement can improve the compliance of patients during CT scanning, reduce the incidence of contrast agent extrava-sation and adverse reactions, and improve the quality of nursing service.
      【Key words】 PDCA management; CT enhanced scanning; Contrast agent extravasation; Prevention; Medical Im-aging Department; Computed tomography·护理·doi:10.3969/j.issn.1003-6350.2019.22.041