Clinical Application Of ICU Quality Control Index In Ones Of Third-Tier General Hospitals In Xinjiang

Objective: To understand the current situation of medical quality control in 11 intensive care of third-tier general hospitals in Xinjiang area,based on the intensive medical professional medical quality control index for the application on the method of continuous quality improvement intervention.Through the propaganda and training of the quality control indexes of the critical care medicine,the application of the quality control index in the clinical work is promoted.Objective to provide scientific and objective reference for the continuous improvement of medical quality of critical care medicine.Methods: This study used a cross-sectional survey,using the index register from July 2016 to October 2016 index related variables,computing intensive medical professional quality control indicators for the baseline variables,medical quality evaluation of severe medical professional medical quality control index.Results: 1.Index application:(1)Structure index:(1)the rate of intensive care unit patients and the rate of bed days in patients with ICU:After the implementation of ICU patients in each area and the rate of bed days were 2.72% and 1.44%.(2)ICU treatment of patients with critical illness:After the implementation of the APACHE II score of more than 15 of patients treated was 64.74%.(2)Process index:3h and 6h bundle treatment completion rate in septic shock、ICU limit the use of antibacterial drugs before the submission rate of pathogen treatment and ICU deep venous thrombosis prevention rate was72.48%,75.56%,74.80% and 59.09%.(3)Outcome indicators : ICU unplanned endotracheal extubation rate 、 The rate of 48 h intubation after extubation in ICU 、Unplanned transfer rate of ICU、ICU returns to 48 h after returning rate、ICU incidence of ventilator associated pneumonia 、 ICU incidence of intravascular catheter-related bloodstream infection and severe medical professional guide infection rate were 2.52%,1.43%,7.05%,1.47%,11.05‰,2.75‰ and 3.50‰.2.Index correlation analysis:(1)Analysis of the correlation between the structural index and the "structural index process index outcome index" :: incidence of 6h infection in patients with septic shock,the rate of 48 h intubation,and the rate of 48 h in patients with severe acute respiratory syndrome were positively correlated with the rate of patients admitted to ICU(P<0.05);There was a positive correlation between the rate of CRBSI and the incidence of VAP in patients with ICU(P<0.05);There was a positive correlation between the severity of disease and unplanned extubation rate,CAUTI incidence(P<0.05)。(2)Analysis of the correlation between process indicators and process indicators : There was a negative correlation between the rate of 6h cluster treatment and the rate of return to 48 h after ICU,the difference was statistically significant(P<0.05)。(3)Correlation analysis between the results and the results:Unplanned extubation rate was positively correlated with the rate of 48 h intubation and the incidence of CAUTI(P<0.05);The rate of endotracheal intubation in 48 h was positively correlated with the rate of unplanned ICU conversion,the rate of 48 h in the ICU,the incidence of VAP and the incidence of CAUTI(P<0.05);The rate of unplanned transfer to ICU was positively correlated with the rate of return to 48 h within ICU(P <0.05).3.Analysis of the relationship between nurses’ structural configuration and outcome indicators: Work experience more than 6 years the proportion of nurses with unplanned extubation rate and the incidence rate of CAUTI was negatively correlated(P<0.05);The nurse nurses accounted for the incidence of VAP and CRBSI and the incidence rate was negatively correlated(P<0.05);The occupation ratio of nurses was negatively correlated with the incidence of VAP(P<0.05).Conclusion: 1.This study confirmed that the severe medical professional medical quality control index for the continuous improvement of the quality of foundation can effectively improve 3the intensive medical professional medical quality,reduce the occurrence of the outcome indicators and improve the level of medical.2.Structural indicators can affect the quality evaluation of medical process,and strengthen the monitoring and management of process indicators,thus changing the outcome of the outcome indicators.3.The allocation of nurses at different levels has a certain impact on the structural indicators,from the rational allocation of human resources,to provide a reference for improving the quality of medical care.