运用PDCA降低神经外科医院感染发病率的临床效果

Clinical effect of application of PDCA on reducing the incidence of healthcareassociated infection in department of neurosurgery

摘要:

目的研究运用PCDA对降低神经外科医院感染发病率的效果。方法成立品管圈活动小组，制定活动方案，采用PDCA四个阶段十个步骤，观察某院神经外科PDCA实施前（2015年9—11月）与实施后（2016年5—7月）医院感染发病率，从手卫生、无菌技术操作、环境清洁卫生执行情况方面分析原因找出对策，并进行为期6个月的质量持续改进。结果PDCA实施前与实施后进行比较，神经外科医院感染发病率由10.9%降低至5.8%，差异有统计学意义（P＜0.05），达标率为100%，实施后医院感染发病率降幅达46.8%；手卫生执行率由27.2%上升至76.9%，无菌技术操作执行率由76.0%上升至96.9%，环境清洁卫生由51.0%上升至90.0%，实施前后比较差异均具有统计学意义（均P＜0.001）。结论多部门联合开展品管圈活动能降低神经外科医院感染发病率，使制度得到落实，措施得到进一步完善，值得在临床推广应用。

Abstract:

ObjectiveTo study the effect of application of plandocheckact (PDCA) on reducing the incidence of healthcareassociated infection(HAI) in department of neurosurgery. MethodsQuality control circle activity group was established, programme of activities was formulated, four stages and ten steps of PDCA were adopted, incidences of HAI in department of neurosurgery before (SeptemberNovember 2015) and after (MayJuly 2016) the implementation of PDCA were observed, causes were analyzed based on implementation of hand hygiene, aseptic technique manipulation, and environmental sanitation, countermeasures were found out, and continuous quality improvement was performed for 6 months.ResultsComparison between before and after implementation of PDCA was conducted, incidence of HAI in department of nerosurgery decreased from 10.9% to 5.8%, difference was significant（P＜0.05）, control rate was 100%, incidence of HAI dropped by 46.8%; hand hygiene implementation rate increased from 27.2% to 76.9%, aseptic technique implementation rate increased from 76.0% to 96.9%, environmental sanitation increased from 51.0% to 90.0%, differences before and after implementation were all statistically significant(all P<0.001). ConclusionQuality control circle activities implemented jointly by multiple departments can reduce the incidence of HAI in department of neurosurgery, rules can be observed, measures can be further improved, it is worthy of clinical application.