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Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication.
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OBJECTIVE: To explore the application effect of quality control circle management in improving the qualified rate of anesthetic drugs prescription in hospital. METHODS: The quality control circle was established to explore the causes of the unqualified anesthetic drugs prescription in our hospital by using the 80/20 rule and fish-bone diagram. The measures to improve the prescription pass rate were determined, and the changes of the prescription pass rate before and after QCC management were compared through the implementation and review of the measures. RESULTS: Using the management of quality control circle, the prescription quality of inpatient anesthetic drugs was significantly improved in our hospital in 2018 and the qualified rate increased from 70.07% in 2017 to 2018 97.78% above target value of 6.69%. After continuous quality control circle management, the qualified rate of prescription increased to 99.33% in the first three quarters of 2019. CONCLUSION: The development of QCC can effectively improve the qualified rate of anesthetic drugs prescription in hospital, not only standardizing the use of anesthetic drugs, promoting drug safety of patients, but also improving the comprehensive quality of pharmacists and the quality of hospital pharmaceutical care.
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Objective@#To explore the effect of quality control circle(QCC)on reducing the incidence of moderate or severe malnutrition in gastric cancer patients under chemotherapy.@*Methods@#Before the activity (February to March 2016), 146 gastric cancer patients under chemotherapy were selected as the control group, and regular nutrition nursing (dietary guidance and regular nutrition-related health lectures) was given. After the activity (February to March 2017), 139 gastric cancer patients under chemotherapy were selected as QCC group, and the standard intervention of quality control circle was implemented. The nutritional status of patients before and after improvement was compared.@*Results@#After finding the cause and formulating and implementing the measures, the 24-hour consultation rate, the incomplete remission rate of nausea/vomiting, the incidence of cancer anorexia, and the rate of missed visits in QCC group were significantly different with those in control group (P<0.05). The incidence of moderate or severe malnutrition was 16.55% in QCC group and 65.07% in control group, and the difference was statistically significant (P<0.01).@*Conclusions@#The quality control circle activity can effectively reduce the incidence of moderate or severe malnutrition and improve the quality of life in gastric cancer patients under chemotherapy. It can also improve the self-discipline and initiative of medical staff and improve the quality of medical care.
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Objective@#To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems.@*Methods@#A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning. SPSS 23.0 software was used to analyze the data.@*Results@#Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures" , accounting for only 6.7%. The "calculation of target value" was the best for 45.1%, the best which "QCC report and evaluation" was 32.1%(72/224) in the promotion and management of hospital-level QCC, and the worst which "standardization approval" was only 4.0%(9/224). The main obstacle factors include personnel, skills and in-hospital support.@*Conclusions@#Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.
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Objective@#To explore the quality control circle (QCC) in midwife practice teaching activities for improving the quality of teaching effect, innovate the method for obstetric practice teaching and provide reference for other practice teaching methods.@*Methods@#Take the 84 midwifery interns as research object who entered the maternity ward within two years after the implementation of the QCC activities, and randomly divided into the experimental group and the control group and each group included 42 people. The experimental group adopted the teaching mode of integrating daily teaching into the QCC. The control group adopted the traditional one-on-one teaching mode based on teaching, and compared the learning effects of the two groups of interns.@*Results@#After the internship, the three levels of the Koch′s four-level training evaluation model method were used to evaluate the teaching effect. The reaction layer was evaluated through five aspects: teaching plan, teacher resources, internship environment, teaching form and content, and appraisal evaluation. It was found that the satisfaction of the teaching plan and teaching form evaluation of the experimental group was significantly higher than that of the control group; the learning level passed the theoretical test. The results of the scores, skills test scores and overall care were evaluated. It was found that the three results of the internship group were significantly higher than those of the control group. The behavioral level was evaluated by the satisfaction of the client and the maternal was proficient in the operation of the experimental group. The satisfaction evaluation of the mission and the mission was significantly higher than the control group. The difference in the above evaluation results was statistically significant (P<0.05).@*Conclusions@#The quality control circle teaching mode is feasible in the midwife internship teaching in the delivery room, which transforms the traditional passive teaching mode into a common and active participation teaching mode for teachers and students, enhances the level and enthusiasm of teachers to teach, and enhances service awareness and quality of care. It also plays a role in cultivating management talents and is worthy of further exploration and promotion.
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Objective To explore the effect of quality control circle (QCC) on reducing the incidence of moderate or severe malnutrition in gastric cancer patients under chemotherapy. Methods Before the activity (February to March 2016), 146 gastric cancer patients under chemotherapy were selected as the control group, and regular nutrition nursing (dietary guidance and regular nutrition-related health lectures) was given. After the activity (February to March 2017), 139 gastric cancer patients under chemotherapy were selected as QCC group, and the standard intervention of quality control circle was implemented. The nutritional status of patients before and after improvement was compared. Results After finding the cause and formulating and implementing the measures, the 24-hour consultation rate, the incomplete remission rate of nausea/ vomiting, the incidence of cancer anorexia, and the rate of missed visits in QCC group were significantly different with those in control group (P<0. 05). The incidence of moderate or severe malnutrition was 16. 55％ in QCC group and 65. 07％ in control group, and the difference was statistically significant (P<0. 01). Conclusions The quality control circle activity can effectively reduce the incidence of moderate or severe malnutrition and improve the quality of life in gastric cancer patients under chemotherapy. It can also improve the self-discipline and initiative of medical staff and improve the quality of medical care.
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Objective To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems. Methods A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning.SPSS 23.0 software was used to analyze the data. Results Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures", accounting for only 6.7% . The"calculation of target value"was the best for 45.1%, the best which"QCC report and evaluation"was 32.1%(72/224) in the promotion and management of hospital- level QCC, and the worst which"standardization approval"was only 4.0% (9/224). The main obstacle factors include personnel, skills and in- hospital support.Conclusions Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.
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Objective To explore the quality control circle (QCC) in midwife practice teaching activities for improving the quality of teaching effect, innovate the method for obstetric practice teaching and provide reference for other practice teaching methods. Methods Take the 84 midwifery interns as research object who entered the maternity ward within two years after the implementation of the QCC activities, and randomly divided into the experimental group and the control group and each group included 42 people. The experimental group adopted the teaching mode of integrating daily teaching into the QCC. The control group adopted the traditional one-on-one teaching mode based on teaching, and compared the learning effects of the two groups of interns. Results After the internship, the three levels of the Koch′s four-level training evaluation model method were used to evaluate the teaching effect. The reaction layer was evaluated through five aspects: teaching plan, teacher resources, internship environment, teaching form and content, and appraisal evaluation. It was found that the satisfaction of the teaching plan and teaching form evaluation of the experimental group was significantly higher than that of the control group; the learning level passed the theoretical test. The results of the scores, skills test scores and overall care were evaluated. It was found that the three results of the internship group were significantly higher than those of the control group. The behavioral level was evaluated by the satisfaction of the client and the maternal was proficient in the operation of the experimental group. The satisfaction evaluation of the mission and the mission was significantly higher than the control group. The difference in the above evaluation results was statistically significant (P<0.05). Conclusions The quality control circle teaching mode is feasible in the midwife internship teaching in the delivery room, which transforms the traditional passive teaching mode into a common and active participation teaching mode for teachers and students, enhances the level and enthusiasm of teachers to teach, and enhances service awareness and quality of care. It also plays a role in cultivating management talents and is worthy of further exploration and promotion.
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Objective To discuss the application of quality control circle with project achievement style in the construction of family-centered care for premature infants. Provide theoretical support for family-centered care model. Methods Set up quality control circle group, select the topic as"construct a family-centered care for premature infants". Carry out activities according to the activity steps of the quality control circle with project achievement style. Advance activities by looking at the support of health care workers, family needs, carrying on the training and the examination to the family member, using the Failure Mode and Effect Analysis (FMEA) to prevent hospital infection and developing discharge plan by trinity model. Then evaluation of tangible and intangible results before and after the activity. Results The growth rate of body mass, breast-feeding rate, length of stay, family satisfaction and family care ability of premature infants after the quality control circle activities were respectively as follow (18.92±0.66) g/kg/d, 47.25％, (23.28 ± 1.39) d, 96.58％, (98.10 ± 12.57) points;before the quality control circle activities all the scores were respectively as follow (17.26 ± 0.38) g/kg/d, 13.45％, (26.40 ± 1.098)d, 80.67％, (61.45 ± 15.07) points. The difference between the two groups was statistically significant(t=7.31, 5.89, 7.52,χ2=34.41, 17.55, P<0.01). The incidence of hospital infection before and after quality control circle activities were respectively (6.11 ± 3.59)％, (5.61 ± 2.19)％,the difference was not statistically significant (χ2=0.262, P>0.05).In addition, we also gained economic and social benefits and many hospitals came to visit and study family-centered care model. Conclusion The family-centered care model is beneficial to the improvement of the nursing quality of premature infants. The activities of the Quality Control Circle with project achievement style can help to improve the participation and acceptance of all medical staff in this model and provide a foundation for the implementation of family-centered care model.
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Objective To explore the effect of quality control circle in decreasing the unqualified rate and improving quality of specimen in clinical laboratory during the pre-analytical phase.Methods The laboratory department of the First Affiliated Hospital of Kunming Medical University established quality control circle management model,since March 1 st to June 1 st 2016,following the steps of the theory and method of quality management.Used professional tools of quality control circle to solve existing problems before procedure.Then compared the disqualification rates before and after the implementation,and used chi-square test for statistical analysis.Results After activity of quality control circle,the unqualified rate of specimen in clinical laboratory declined from 0.565%to 0.220%.The difference was statistically significant (χ2=155.22,P<0.01), the goal achievement was 86.25%,the advance rate was 61.06%.And the ability of employees in using scientific means have improved.The ability of using quality control tools increased by 33.3%,the problem solving ability increased by 9.3%, the coordination and communication ability increased by 125%,the team cohesion increased by 56%and the enthusiasm increased by 20.7%. Conclusion With the application of quality control circle tools,the unqualified rate of specimen decreases and the ability of solving problems by applying of quality control circle tools.(Chin J Lab Med,2018,41:324-327)
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Objective: To explore the management methods for radiotherapy technologist, and standardize the management for the team of radiologic technologist. Methods: The effect of technologist in the radiotherapy and the current situation of team construction for radiotherapy technologist were analyzed. Quality control circle method was depended on to enhance the medical service quality in routine work. And emergency manoeuvre was adopted to enhance disposal capability for sudden events in the train management of work staff. Results: In routine management, the new radiologic technologists and the technologist with experiences were required as uniform standards. While in the training management, they were discriminatory. And these methods contribute to establish the team of radiologic technologist. Conclusion: To standardize the management for the team of radiologic technologist, and enhance the management level of the team will contribute to ensure the accurate execution of radiotherapy plan and enhance the service quality of them.
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OBJECTIVE; To improve the PIVAS quality management, reduce dispensing error and promote the safety of drug use.METHODS: The quality control circle (QCC) was used for quality management in PIVAS of our hospital. The reasons for dispensing errors were analyzed to determine the key improvement points using "the reduction of dispensing error of admixture drugs" as theme. Improvement plan was formulated, and effective countermeasures were determined by PDCA (Plan, Do, Check, Action) cycle management. The tangible results (the rate of dispensing errors) and intangible results were compared before (Feb. 2016) and after QCC (Aug. 2016). RESULTS: Some effective measures were formulated and implemented, including unified arrangement, introducing PIVAS MATE process management software, personnel post training, refining drug withdrawal management, visual management, etc. The tangible results included the rate of dispensing error decreased from 1. 81‰ to 0. 53‰; the rate of goal achievement reached 108. 47％; the rate of target progress was 70. 72％. The intangible results included optimizing drug dispensing process, standardizing drug withdrawal systent and personal training system. Those achievement improved confidence, responsibility, sense of cooperation and cohesiveness of QCC members. Additional result was obtained, i. e. utility model patent for avoiding light storage box. CONCLUSIONS: QCC can effectively improve the management quality of PIVAS workflow and the safety of intravenous medication.
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OBJECTIVE: To shorten drug dispensing time of inpatient pharmacy in our hospital, and to enhance the quality of pharmaceutical care.METHODS: The activity of quality control circle (QCC) was carried out by using "shorten drug dispensing time of inpatient pharmacy" as subject. According to the steps of QCC activity, key links and factors that influence the of drug dispensing time in the inpatient pharmacy were found out. Countermeasures were formulated and implemented according to practical reasons. The activity was evaluated by using the drug dispensing time in every 100 medical orders before and after QCC activity. RESULTS: According to the links of "dispensing medical order" and "checking medical order" that spent longest time, the countermeasures were put forward to improve work efficiency, such as rational drug distribution and design, opmitization of the dispensing route, realizing electronic large infusion prescription by strengthening system informatization, strengthening the management of confusing drugs, strengthening staff training and establishing performance appraisal system. The drug dispensing time was shortened from 43. 99 min (before QCC) to 21. 77 min (after QCC), and target achievement rate was 99. 24％. QCC staff showed positive growth in means, responsibility, team cohesion and other aspects. CONCLUSIONS: QCC activity can shorten the time of drug dispensing, improve work efficiency and pharmacist' s ability of solving problem, and help to improve pharmaceutical care in the inpatient pharmacy.
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OBJECTIVE:To reduce drug repercussion of outpatient pharmacy,and to promote safe drug use.METHODS:By quality control circle (QCC),the data of drug repercussion were selected from outpatient pharmacy of our hospital in Sept.2016.The drug repercussion reason check list was designed to master the situation of drug repercussion in outpatient department,formulate improvement measures and confirm effect through field inspection.The case number of drug repercussion and the improvement of circle members' ability were compared one month before and after QCC (Mar.2017).Finally,the effects of QCC were evaluated.RESULTS:Referring to the reasons for the repercussion of adjunct drugs for inspection and the repercussion of unsuitable drug use in our hospital,those problems were improved by formulating manual for drug use examination project,optimizing and examining drug delivery process in the department,etc.The case number of drug repercussion in outpatient pharmacy decreased from 31 cases per month to 12 cases per month;the rate of goal achievement was 119％;the rate of improvement was 61％.The ability of QCC members to solve problems and the ability to use QCC skills were increased positively.CONCLUSIONS:The development of QCC activity in our hospital reduces case number of drug repercussion and optimizes drug delivery process in outpatient pharmacy,and promotes safe drug use.
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OBJECTIVE:To provide reference for improving drug dispensing speed of pharmacy intravenous admixture services (PIVAS).METHODS:The reasons for slow drug dispensing in PIVAS of our hospital were analyzed,quality control circle (QCC) activity was conducted according to ten steps as subject selection,plan formulation,current situation control,goal setting,goal analysis,countermeasure formulation,countermeasure implementation and review,effect confirmation,standardization,review and improvement.The effect of QCC activity was evaluated by drug dispensing speed and the rate of drug dispensing error.RESULTS:Main reasons for slow drug dispensing in PIVAS in our hospital included not fixed position of the infusion bag,insufficient pre-dispensing drug basket,not unified method of sticking doctor's order labels,not eye-catching drag position identification,unreasonable drug shelf position.Drug dispensing speed increased from 2.99 bag/person/min to 4.90 bag/person/min,and the target yield rate was 95％ through displacing injection according to the doctor's order,re-making the drug shelf logo,preparing adequate pre-dispensing basket in advance,sticking the prescription tag of medical order standardly,etc.The rate of drug dispensing error decreased from 0.005％ to 0.002％ after improving and optimizing drug dispensing procedure.CONCLUSIONS:The application of QCC activity,improvement and optimization of drug dispensing procedure in PIVAS in our hospital not only improve drug dispensing speed in PIVAS,but also reduce the rate of drug dispensing error.
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Objective To discuss the effect of Quality Control Circle activity optimize Traditional Chinese Medicine (TCM) nursing program in improving the recovery of gastrointestinal function after cesarean section. Methods In the management of applying QCC method to optimize TCM nursing program to promote the recovery of gastrointestinal function after cesarean section. The study was conducted on patients with cesarean section of the department of obstetrics and gynecology of shenzhen hospital of Guangzhou university of traditional chinese medicine (Futian). 36 cases of the control group were patients before the optimization of TCM nursing program by QCC on February 13-26, 2017, and 36 cases of the intervention group were patients after that on July 2 to 15, 2017. Before and after the QCC program, the time of postoperative of cesarean section patients' first anus exhaust, anal exhaust rate in 18 hours and lactation time were compared. The postoperative of cesarean section patients′first anus exhaust time, 18 hours anal exhaust rate and lactation time were investigated , and essential factors and really causes of the anal exhaust rate in 18 hours were analyzed, and a corresponding countermeasures were made. Results After TCM nursing program, the postoperative of cesarean section patients′ first anus exhaust time and lactation time were significant reduced (P<0.05);anal exhaust ratein 18 hours wasrise from 22.2％(8/36) to 86.1％(31/36). The patients after cesarean sectionwhose anal exhaust rate in 18 hours was increased significantly. The target success rate was as high as 116％, and the recovery rate was as high as 287.8％. Conclusions QCC activity optimize TCM nursing program can improve the recovery of gastrointestinal function after cesarean section. It enriched the connotation of TCM nursing programs, promote the implementation and standardizes the operation process of it. It also improved the clinical efficacy of TCM nursing program, and indeed promoted the patients′ gastrointestinal function after cesarean section, so that it is worthy of clinical application.
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Objective To systematically evaluate the application effect of the quality control circle(QCC)in the complications after PICC catheterization.Methods The randomized controlled trials(RCTs)on the application effect of QCC after PICC catheter-ization were retrieved from the Cochane library,PubMed,EMBASE,Chinese Biomedical literature Database(CBM),China Academic Journal Full-text Database(CNKI),VIP and Wangfang Database by computer.The literatures were selected according to the inclu-sion and exclusion criteria.The two valuators independently retrieved and screened the literatures,extracted the data,evaluated the methodological quality of included literatures and conducted the cross check.Then the meta analysis was performed by using Rev-Man 5.3 software.Results A total of 7 914 articles were retrieved,finally 14 RCTs were included,involving 2 728 patients.The oc-currence rates of phlebitis,catheter obstruction,unplanned extubation and catheter-related blood flow infection in the intervention group were lower than those in the control group,the difference was statistically significant(OR=0.28,95% CI:0.16-0.48,P<0.01;OR=0.27,95% CI:0.17-0.42,P<0.01,OR=0.27,95% CI:0.18 -0.39,P<0.01;OR=0.25,95% CI:0.13 -0.49,P<0.01).Conclusion Using QCC is conducive to reduce the complication incidence rate after PICC catheterization.
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To explore the effect and experience of quality control circle(QCC) in quality control testing for CT scanners, the quality control circle group was set up to determine the theme of quality control circle, and the causes of the failure of the quality control testing for CT scanners were analyzed, then the corresponding corrective measures were formulated and carried out. After the activity of the quality control circle, the qualified rate of CT quality control testing in the second level 2nd Class of public hospitals and private hospitals in Shanghai increased from 40.6% to 86.1%. By conducting quality control circle activities, we found the problems existed in the quality control testing of CT scanners, and put forward many corresponding corrective measures and solutions which finally improved the qualified rate of CT quality control testing.
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China , Quality Control , Tomography Scanners, X-Ray Computed , Reference Standards , Tomography, X-Ray ComputedABSTRACT
Objective To explore the prospective monitoring and control methods for missing reporting of health-care-associated infection(HAI)cases,analyze its implementation efficacy,provide basis for formulating targeted strategy for monitoring missing report of HAI.Methods From January 2016 to June 2017,the quality control circle (QCC)method was used to prospectively monitor HAI cases in hospitalized patients,missing reporting of HAI was controlled.Results "Information system intelligence screening+mobile messaging alerts+ HAI supervision"trinity monitoring model for avoid missing reporting of HAI cases was established,after the first round of PDCA(plan, do,check,action)cycle,missing reporting rate of HAI decreased from 79.16% before QCC to 59.75% after QCC, difference was statistically significant (χ2＝208.821,P＝0.000).Compared with missing reporting rate of HAI af-ter the first round of PDCA,missing reporting rate of HAI after the second round of PDCA dropped to 26.18%, difference was statistically significant (χ2＝200.075,P＝0.002).Conclusion Active prospective prevention and control before missing reporting of HAI can effectively avoid missing reporting of HAI cases.
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Objective To improve the qualified rate of cleaning of loaner orthopedic surgery instruments by application of quality control circle(QCC).Methods QCC activity was carried out in a hospital from May to October 2016, on-site assessment of cleaning quality was performed by two circle members, causes of unqualified cleaning result of loaner orthopedic surgery instruments were recorded, the qualified result of loaner orthopedic surgery instruments before QCC activity(May-June 2016)and after QCC activity(September-October 2016)was compared. Results Before QCC activity, there were 1 667 packages of loaner instruments, 1 415 were qualified for cleaning, qualified rate was 84.88％;after activity, there were 1 673 packages of loaner instruments, 1 655 were qualified for cleaning, qualified rate was 98.92％, difference was statistically significant between two groups(P＜0.01), qualified rate increased to 14.04％, target achievement rate was 116％.Conclusion Application of the scientific tool of QCC can improve the qualified rate of cleaning of loaner orthopedic surgery instruments.