目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
Operating Room, Qidong People's Hospital, Jiangsu Province, Qidong 226200, Jiangsu, China
Objective: To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.
目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
论著
目的 探讨计划-实施-检查-处理(PDCA)循环法及根本原因分析法在持续正压通气治疗重症肺炎患儿中的应用效果。方法 选取2021年1月—2023年1月医院收治并接受鼻塞式持续正压通气治疗的重症肺炎患儿80例,基于随机数字表法分为两组,每组各40例。对照组接受常规护理,观察组采用PDCA循环法联合根本原因分析法护理干预。比较两组临床症状改善时间、血气指标[动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、动脉血二氧化碳分压(PaCO2)]、肺功能指标[第1秒用力呼气容积(FEV1)、潮气量(VT)]、炎症免疫指标[单核细胞趋化蛋白-1(MCP-1)、可溶性髓系细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)]水平变化,比较两组患儿家属满意度情况。结果 观察组患儿咳嗽、气促、哮鸣音、心率恢复及紫绀等症状改善用时均低于对照组,比较差异有统计学意义(P<0.05)。干预前,两组患儿PaO2、SaO2、PaCO2、FEV1、VT、MCP-1、sTREM-1、sICAM-1水平比较差异均无统计学意义(P>0.05);干预后,两组患儿上述指标水平均有不同程度变化(P<0.05),观察组PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg)、SaO2(93.58±3.82% vs 86.30±4.21%)、FEV1(2.66±0.46 L vs 1.97±0.34 L)、VT(11.92±1.89% vs 9.83±1.10%)水平均高于对照组,观察组PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg)、MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L)、sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)、sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)水平低于对照组,差异均有统计学意义(P<0.05)。观察组患儿家属满意度整体优于对照组(P<0.05);观察组总满意率(97.5% vs 77.5%)高于对照组,差异有统计学意义(P<0.05)。结论 PDCA循环法及根本原因分析法应用于接受持续正压通气治疗的重症肺炎患儿,能够有效促进患儿临床症状改善,有利于血气及肺功能恢复,且可降低炎症反应,患儿家属满意度较高。
Objective To explore the application effect of Plan-Do-Check-Action(PDCA)circulation method and root cause analysis method in the treatment of children with severe pneumonia with continuous positive pressure ventilation.Methods From January 2021 to January 2023,80 children with severe pneumonia who were admitted to hospital and received nasal plug continuous positive pressure ventilation treatment were enrolled in this study.Based on the random number table method,they were divided into two groups,with 40 cases in each group.The control group received routine nursing,while the observation group received PDCA circulation method combined with root cause analysis nursing intervention.The improvement time of clinical symptoms,changes in blood gas indicators[arterial partial oxygen pressure(PaO2),arterial oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2)],lung function indicators [(forced expiratory volume in 1 second,FEV1),tidal volume(VT)],and inflammatory immune indicators [monocyte chemotactic protein-1(MCP-1),soluble myeloid cell trigger receptor-1(sTREM-1),soluble intercellular adhesion molecule-1(sICAM-1)] levels between the two groups were compared,and the family members’ satisfaction of the two groups was also compared.Results The improvement time for symptoms such as cough,shortness of breath,wheezing,heart rate recovery and cyanosis in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before intervention,there was no statistically significant difference in the levels of PaO2,SaO2,PaCO2,FEV1,VT,MCP-1,sTREM-1 and sICAM-1 between the two groups of children(P>0.05).After intervention,the levels of the above indicators in both groups of children showed varying degrees of change(P<0.05).The levels of PaO2(97.18±7.90 mmHg vs 90.30±7.12 mmHg),SaO2(93.58±3.82% vs 86.30±4.21%),FEV1(2.66±0.46 L vs 1.97±0.34 L),VT(11.92±1.89% vs 9.83±1.10%)in the observation group were higher than those in the control group.The levels of PaCO2(36.70±3.97 mmHg vs 40.65±3.79 mmHg),MCP-1(58.45±11.94 ng/L vs 74.46±16.69 ng/L),sTREM-1(36.25±8.30 ng/L vs 51.57±9.51 ng/L)and sICAM-1(187.52±31.22 mg/L vs 243.73±46.79 mg/L)in the observation group were lower than those of the control group,with statistically significant differences(P<0.05).The overall satisfaction of the observation group was better than that of the control group(P<0.05),the total family members’ satisfaction rate of the observation group was higher than that of the control group(97.5% vs 77.5%),with a statistically significant difference(P<0.05).Conclusions PDCA circulation method and root cause analysis method applied to children with severe pneumonia who receive continuous positive pressure ventilation treatment,can effectively promote the improvement of clinical symptoms,be conducive to the recovery of blood gas and lung function,and reduce inflammatory reaction,with high family members’ satisfaction.