关键词: 结核, 肺, 痰, 标本制备, 诊疗工作管理, 医学, 对比研究

Abstract:

Objective To explore the application effect of target management in quality control of sputum specimens retention of initially treated pulmonary tuberculosis patients.Methods A total of 338 initially treated pulmonary tuberculosis patients were collected as subjects, who were hospitalized because of suspected tuberculosis and then were diagnosed and accepted the treatment in Tuberculosis Department of Shanghai Pulmonary Hospital from July 2017 to December 2017. They were divided into two groups: the observation group (N=165, patients hospitalized in the Ward 5 of Tuberculosis Department) and the control group (N=173, patients in the Ward 1). The patients in the control group received the routine nursing management in tuberculosis department, and the pro-paganda and education of sputum specimen retention. Meanwhile, sputum specimen retention and the standard inspections were supervised and inspected. In addition to these routine managements, patients in the observation group accepted other target management approaches for the sputum specimen retention, namely doctors, nurses and patients jointly involved and determined the overall target of sputum specimen retention, and decomposed the overall target into sub-targets, and finally reached the overall target by sub-target setting, target implementing, feedback processing, and implementation results checking. The completion rate, qualified rate and positive rate of Mycobacterium smear in sputum samples between the two groups were compared.Results In observation group, 502 sputum specimens were supposed to be retained, and 476 were actually remained, among them 432 were qualified and 312 were positive for Mycobacterium smear. In control group, 524 sputum specimens were supposed to be retained, and 431 were actually remained, among them, 307 were qualified and 172 were positive for Mycobacterium smear. In observation group, the completion rate of retention of sputum specimens was 94.82% (476/502), qualified rate was 90.76% (432/476), and positive rate of Mycobacterium smear was 72.22% (312/432). All of them were higher than that in control group (completion rate: 82.25% (431/524), qualified rate 71.23% (307/431), positive rate of Mycobacterium smear 56.03% (172/307)). The difference was statistically significant (χ ² were 39.50, 57.15, 20.83, P<0.01).Conclusion Target management can improve the initiative of sputum sample retention, the quality and positive rate of sputum samples, and is beneficial to the early diagnosis of suspected pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary, Sputum, Specimen handling, Practice management, medical, Comparative study