广西医学

目的分析广西人类辅助生殖护理质量控制管理现状，并提出相应的优化策略。方法选取广西19家开展体外受精-胚胎移植及其衍生技术的辅助生殖机构作为研究对象。将2021—2022年和2023—2024年分别作为第1周期和第2周期，对19家机构第1周期和第2周期的护理校验评审资料（涵盖落实病案管理制度、落实身份识别制度、落实机构随访标准、护理管理能力等）进行对比分析。结果第2周期有15家（78.95%）机构的护理校验评审得分呈正增长，得分均值较第1周期提高10.43%。19家机构第2周期总取卵周期数较第1周期增长6.38%，护理人员人数增长5.93%。第2周期的落实病案管理制度、落实身份识别制度、落实机构随访标准评审得分均高于第1周期（P<0.05），存在问题的机构数量下降。第2周期存在质量控制管理不到位、岗位设置不合理和岗位职责不明、护理操作规范欠完善、应急预案与风险管理不足等问题的机构数量较第1周期有所减少。涉及落实病案管理制度与落实机构随访标准的问题影响范围较大，而涉及落实身份识别制度的问题影响范围较小。结论广西通过构建校验及质量控制体系、强化培训等措施，生殖护理质量与管理水平显著提升，但仍存在病案管理制度、机构随访标准、身份识别制度落实不到位及护理管理能力有待加强等问题。建议通过完善三级质量控制体系、加强人员培训与考核、深入推进标准化建设等策略持续优化，以保障辅助生殖护理质量与患者安全。

Objective To analyze the current status of human assisted reproductive nursing quality control management in Guangxi, and to propose corresponding optimization strategies. Methods Nineteen assisted reproductive technology institutions approved to perform in vitro fertilization⁃embryo transfer and its derivative technologies in Guangxi were selected as the research subjects. The periods between 2021 and 2022 as well as between 2023 and 2024 were designated as cycle 1 and cycle 2, respectively. The nursing validation review data (covering the implementation of medical record management system, identification system, institutional follow⁃up standards, and nursing management capacity) from cycle 1 and cycle 2 of the 19 institutions were comparatively analyzed. Results In cycle 2, 15 institutions (78.95%) exhibited positive growth in their nursing validation review scores, with the mean score increasing by 10.43% compared to cycle 1. The total number of oocyte retrieval cycles across the 19 institutions in cycle 2 increased by 6.38% compared with cycle 1, and the number of nursing staff increased by 5.93%. The review scores for implementing the medical record management system, identification system, and institutional follow⁃up standards in cycle 2 were higher than those in cycle 1 (P<0.05), and the number of institutions with problems decreased. In cycle 2, the number of institutions with issues such as inadequate quality control management, unreasonable job allocation and unclear job responsibilities, imperfect nursing operation standards, and insufficient emergency plans and risk management decreased compared with cycle 1. Problems related to the implementation of the medical record management system and institutional follow⁃up standards had a wider scope of impact, while problems related to the implementation of the identification system had a smaller scope of impact. Conclusion Through measures such as establishing a validation and quality control system and strengthening training, the quality and management level of reproductive nursing in Guangxi have significantly improved. However, issues remain, including inadequate implementation of the medical record management system, institutional follow⁃up standards, and identification system, as well as the need to strengthen nursing management capacity. It is recommended to continuously optimize through strategies such as improving the three⁃level quality control system, strengthening personnel training and assessment, and advancing standardization construction, so as to ensure assisted reproductive nursing quality and patients' safety.

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