构建自体动静脉内瘘全程链式管理模式

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中图分类号：R197.323;R543 文献标识码：B

Abstract Objective To establish a comprehensive chain management model for autogenous arteriovenous fistula （AVF）.MethodsQuality Control Circle （QCC）activities were conducted folowing the steps of a research-oriented QCC project.Improvements were made through analyzing the current status，identifying key challenges，and formulating strategies，which included establishing a multidisciplinary team，developing a home一based management model， constructing a hierarchical and multi一dimensional risk management system，and implementing comprehensive home一 hospital care. Results The rate of immature AVF decreased from 17% to 8.6% ; the long-term patency rate of AVF increased from 75% to 84.6% ; the success rate of the first puncture for AVF improved from 92.4% to 99.2% ;patients ‘awareness of AVF maintenance knowledge increased from 25.9 points to 39.12 points;the implementation rate of the rope—ladder puncture technique for AVF increased from 92.5% to 100% ; and the incidence of long-term complications of AVF decreased from 34.6% to 18.6% .ConclusionBy conducting QCC activities， a comprehensive chain management model for AVF was established，which prolonged the servicelifeofAVF，reduced theincidence of complications， and improved the quality of hemodialysis.

Key words Quality Control Circle；Research-Oriented Quality Control Circle;Autogenous Arteriovenous Fistula;Comprehensive Chain Management; Hemodialysis; Nursing Quality

主题选定

全体圈员采用头脑风暴法，结合科室现状，集思广益，共拟订8个备选主题，同时采用权重法及“5一3一1”评分法，从上级重视度、重要性、迫切性、圈能力4个维度进行评价，最终选定得分最高的“构建自体动静脉内瘘全程链式管理模式”为本期活动主题。（剩余8123字）