Practice research on the reduction of the incidence of stage 2 and above pressure ulcers in inpatients based on the PDCA cycle and multidisciplinary
基于PDCA循环联合多学科协作降低住院患者2期及以上压力性损伤发生率的实践研究

摘要

目的 系统评价PDCA循环理论框架下多学科协作模式对住院患者2期及以上压力性损伤（Pressure Injury，PI）的防控效果。方法 以赤峰宝山医院2023年1月-2024年12月住院患者为研究对象，组建跨学科质量管理团队，实施PDCA循环质量改进。比较干预前后质量指标差异。结果 实施后2期及以上PI发生率由基线0.057%（95%CI：0.043-0.071）下降至0.012%（95%CI：0.005-0.019）（χ²=27.34，P<0.001，OR=0.21）。干预后高危患者评估延迟率低于干预前，体位管理合格率高于干预前，干预后平均住院时间短于干预前（P＜0.05）。结论 PDCA循环联合多学科协作能有效降低住院患者2期及以上压力性损伤发生率，缩短患者住院时间，为医疗机构质量改进提供理论依据和实践范式。

Abstract

Objective To systematically evaluate the effect of multidisciplinary collaborative models under the theoretical framework of PDCA cycle on the prevention and control of injuries (PIs) of stage 2 or above in inpatients.
Methods The inpatients of Boshan Hospital in Chifeng from January 203 to December 2024 were studied as subjects. An interdisciplinary quality management team was established to implement PDCA cycle quality improvement. The differences in quality indicators before and the intervention were compared.
Results After the implementation, the incidence of PIs of stage 2 or above was reduced from the baseline of 0.057% (5% CI: 0.043–0.071) to 0.012% (95% CI: 0.00–0.019) (χ² = 27.34, P < 0.001, OR = 0.21). The of delayed assessment of high-risk patients was lower after the intervention than before the intervention, and the qualified rate of body position management was higher after the intervention than before the intervention The average length of stay after the intervention was shorter than that before the intervention (P < 0.05).
Conclusion   PDCA cycle combined with multidisciplinary can effectively reduce the incidence of stage 2 or above pressure injuries in inpatients, shorten the length of hospital stay, and provide theoretical basis and practical paradigm for quality improvement in institutions.