系统性医嘱干预提高术前无损备皮依从性
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摘要
目的探讨系统性医嘱干预对提高术前无损备皮依从性的效果,以提升医院感染管理效率。方法北京市某三甲医院就术前无损备皮这一理念对全院医护人员在2013年进行了传统宣教干预,在2015年利用HIS中备皮医嘱选项进行系统性干预,然后从HIS系统导出干预前后的医嘱数据,分析干预后的依从性。结果 2012年至2017年间该医院共报告Ⅰ类切口手术153915例,在2013年进行传统宣教的干预后,该院Ⅰ类切口手术无损备皮率由2012年的4.58%上升至2013年的14.64%(P<0.05);2015年在系统性医嘱干预后,无损备皮率由2014年的16.47%上升至2015年的40.26%(P<0.05)。直至2017年该院无损备皮率达到59.81%。结论两种干预方法均提高了无损备皮率的依从性,系统性医嘱干预相对于传统宣教干预效果更显著。
Objective To explore the effect of systematic medical order intervention measures on preoperative non-destructive skin preparation order, improving the efficiency of hospital infection management. Methods The concept of non-destructive skin preparation before the operation of a three grade hospital in Beijing has carried out a systematic intervention on the individual intervention and the changes of the medical advice options of the HIS system in 2013 and 2015. The data of doctor's orders before and after intervention were derived from the HIS system,and the effect of intervention was analyzed. Results A total of 153915 cases of type I incision operation between2012 to 2017. The rate of non-destructive skin preparation for type I incision surgery increased from 4.58%(2012)to 14.64%(2013)(P<0.05); After the systematic intervention in 2015, the rate of non-destructive skin preparation increased from 16.47%(2014) to 40.26%(2015)(P<0.05). The rate of non-destructive skin preparation reached 59.81% until 2017. Conclusion Two intervention methods all played an effective role, and the effect of systematic medical orders was more significant than traditional propaganda intervention.
Objective To explore the effect of systematic medical order intervention measures on preoperative non-destructive skin preparation order, improving the efficiency of hospital infection management. Methods The concept of non-destructive skin preparation before the operation of a three grade hospital in Beijing has carried out a systematic intervention on the individual intervention and the changes of the medical advice options of the HIS system in 2013 and 2015. The data of doctor's orders before and after intervention were derived from the HIS system,and the effect of intervention was analyzed. Results A total of 153915 cases of type I incision operation between2012 to 2017. The rate of non-destructive skin preparation for type I incision surgery increased from 4.58%(2012)to 14.64%(2013)(P<0.05); After the systematic intervention in 2015, the rate of non-destructive skin preparation increased from 16.47%(2014) to 40.26%(2015)(P<0.05). The rate of non-destructive skin preparation reached 59.81% until 2017. Conclusion Two intervention methods all played an effective role, and the effect of systematic medical orders was more significant than traditional propaganda intervention.
引文
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[2]王清妍,韩月欣,逄丽华,等.不同皮肤准备方法对骨科手术部位感染的影响[J].中华医院感染学杂志,2016(03):625-626
[3]Lefebvre A,Saliou P,Lucet JC,et al.Preoperative hair removal and surgical site infections:network meta-analysis of randomized controlled trials[J].Journal of Hospital Infection,2015,91(2):100-108
[4]曹洋,刘坤,袁晓宁,等.全国187所医院腹部手术术前皮肤准备现状调查[J].中国感染控制杂志,2016(09):676-680
[5]三级综合医院的医院感染管理现状与改进措施_乔建华[J].
[6]李晖,曹迎东,侯睿,等.微信公众号培训实习生对其医院感染防控行为的影响研究[J].中华医院感染学杂志,2018(06):953-956
[7]范雯怡,胥雪冬,袁晓宁.医院管理者对职业卫生管理的理解分析[J].中华医院感染学杂志,2016(23):5494-5496
[8]何建权.信息化新形势下医院管理模式的发展变革探析[J].2014
[9]赵艳春,贾建侠,任军红,等.综合干预措施对医院感染预防控制效果的影响[J].中华医院感染学杂志,2016(18):4308-4310
[10]佟青,张一兵,白璐.医院感染多系统网络信息化交互性管理的实践与实效[J].中华医院感染学杂志,2013(23):5759-5761
[11]匡季秋,邓世洲,刘帆,等.基于失效模式及效应分析模型的医院感染风险管理与预警体系构建研究[J].中华医院感染学杂志,2015(21):4976-4978.