根因循环管理模式提高胚胎移植患者术前膀胱充盈合格率的研究 [中文引用][英文引用]

目的  探讨应用根因循环管理模式（root cause analysis and plan-do-check-act cycle，RCA-PDCA）提高胚胎移植患者术前膀胱充盈合格率，改善患者手术体验，为临床护理管理提供参考。方法  采用前 - 后对照研究，选取 2024 年 1 月至 4 月在本市某三级甲等专科医院生殖科行胚胎移植术的患者为研究对象，将 2024 年 1 月至 2 月行胚胎移植术的 130 例患者设为对照组，2024 年 3 月至 4 月行胚胎移植术的 136 例患者设为试验组。对照组采用常规护理，试验组采用 RCA-PDCA 模式构建护理管理方案。比较措施实施前后两组患者膀胱充盈合格率、子宫内膜显影清晰率、器械辅助移植率和膀胱充盈舒适度的差异。结果  对照组 126 例完成研究，试验组 131 例完成研究。试验组患者膀胱充盈合格率和子宫内膜显影清晰率分别为 70.2% 和81.7%，均高于对照组 38.1% 和 51.6%；试验组患者器械辅助移植率为 2.3%，低于对照组的 7.9%；试验组患者膀胱充盈不适发生率为 32.1%，低于对照组 53.2%，两组比较，差异均有统计学意义（均 P<0.05）。结论  应用 RCA-PDCA 有助于提高胚胎移植患者术前膀胱充盈合格率和子宫内膜显影清晰率，降低器械辅助移植率，改善患者膀胱充盈舒适度。

Objective To enhance the qualified rate of preoperative bladder filling and improve the experience of embryotransfer by implementing a nursing intervention based on the root cause analysis and plan-do-check-act（RCA-PDCA）cycle.Methods A before-after comparative study was conducted among the patients who received embryo transfer at a Tire-IIIA specialisthospital between January and April 2024. The patient who received embryo transfer between January and February 2024（n=130）wereassigned to the control group with routine nursing. Those who received embryo transfer between March and April 2024 were assigned tothe trial group（n=136）with nursing intervention based on RCA-PDCA. The two groups were compared in terms of the qualified rate ofbladder filling，endometrial visualisation rate，instrument-assisted transfer rate and level of comfort. Results A total of 126 women inthe control group and 131 in the trial group completed the study. The patient in the trial group demonstrated significantly higher qualified