PDCA循环管理在急诊医院感染预防与控制中的应用研究
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摘要
目的 探讨分析PDCA循环管理模式在急诊医院感染预防和控制中应用的效果。方法 将2013年11月-2014年11月急诊就诊患者纳为对照组,2014年12月-2015年11月急诊就诊患者纳为研究组,各362例;对照组患者行常规感染控制管理;研究组患者行PDCA循环管理,观察两组患者医院感染率,病原菌检出率以及医院感染环境监测相关指标的抽检结果和医院感染预防措施执行率,并对两组患者急诊感染管理工作满意度进行比较。结果 研究组患者医院感染率、病原菌检出率均低于对照组(P<0.05);研究组患者医院感染预防措施执行率高于对照组(P<0.05),同时治疗室空气培养和物体表面细胞学监测合格率也高于对照组(P<0.05);研究组患者急诊感染管理工作满意度高于对照组(P<0.05)。结论 急诊医院感染预防和控制中开展PDCA循环管理模式能够有效降低医院感染发生率,增强感染防控实施力度,提高患者对急诊感染管理工作的满意度。
OBJECTIVE To explore and observe the effect of PDCA circulation management model on prevention and control of nosocomial infection in emergency department. METHODS The patients who were treated in the hospital from Nov 2013 to Nov 2014 were assigned as the control group, and the patients who were treated in emergency department from Dec 2014 to Nov 2015 were chosen as the study group, with 362 cases in each group. The conventional infection control and management was carried out in the control group, and the PDCA circulation management was implemented in the study group. The incidence of nosocomial infection, isolation rate of pathogens, environmental monitoring-related indexes for nosocomial infection and implementation rate of prevention measures were observed, and the satisfaction with the control of infection in emergency department was observed and compared between the two groups of patients. RESULTS The incidence of nosocomial infection and isolation rate of pathogens were significantly lower in the study group than in the control group(P<0.05). The implementation rate of prevention measures of the study group was significantly higher than that of the control group(P<0.05). The qualified rates of cytological monitoring of air culture in treatment room and object surfaces were significantly higher in the study group than in the control group(P<0.05).The patients' satisfaction with the control of infection in emergency department was significantly higher in the study group than in the control group(P<0.05). CONCLUSION The PDCA circulation management model may effectively reduce the incidence of nosocomial infection in the emergency department, enhance the efforts of implementation of prevention measures and raise the patients' satisfaction with the control of infection in the emergency department.
OBJECTIVE To explore and observe the effect of PDCA circulation management model on prevention and control of nosocomial infection in emergency department. METHODS The patients who were treated in the hospital from Nov 2013 to Nov 2014 were assigned as the control group, and the patients who were treated in emergency department from Dec 2014 to Nov 2015 were chosen as the study group, with 362 cases in each group. The conventional infection control and management was carried out in the control group, and the PDCA circulation management was implemented in the study group. The incidence of nosocomial infection, isolation rate of pathogens, environmental monitoring-related indexes for nosocomial infection and implementation rate of prevention measures were observed, and the satisfaction with the control of infection in emergency department was observed and compared between the two groups of patients. RESULTS The incidence of nosocomial infection and isolation rate of pathogens were significantly lower in the study group than in the control group(P<0.05). The implementation rate of prevention measures of the study group was significantly higher than that of the control group(P<0.05). The qualified rates of cytological monitoring of air culture in treatment room and object surfaces were significantly higher in the study group than in the control group(P<0.05).The patients' satisfaction with the control of infection in emergency department was significantly higher in the study group than in the control group(P<0.05). CONCLUSION The PDCA circulation management model may effectively reduce the incidence of nosocomial infection in the emergency department, enhance the efforts of implementation of prevention measures and raise the patients' satisfaction with the control of infection in the emergency department.
引文
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[2] da Cruz MK,Morais TM,Trevisani DM.Clinical assessment of the oral cavity of patients hospitalized in an intensive care unit of an emergency hospital[J].Rev Bras Ter Intensiva,2014,26(4):379-383.
[3] 薛荫青.精细化流程管理在手术室医院感染控制中的效果分析[J].河北医学,2016,22(5):851-853.
[4] Ueda A,Saito T,Ueda M,et al.Introduction and PDCA-management of a liaison-clinical pathway with cancer patients after a curative operation[J].Gan To Kagaku Ryoho,2015,42(10):1197-1201.
[5] 邓艳.PDCA循环模式在医院感染管理中的应用效果[J].实用临床医药杂志,2016,20(4):187-188.
[6] 王晖,李勐,张晓丽,等.PDCA管理模式在神经外科重症监护病房医院感染管理中的应用及其效果评价[J].中国医药导刊,2017,19(10):73-77.
[7] McIlvennan CK,Eapen ZJ,Allen LA.Hospital readmissions reduction program[J].Circulation,2015,131(20):1796-1803.
[8] Silkens MEWM,Lombarts KMJMH,Scherpbier AJJA,et al.Towards healthy learning climates in postgraduate medical education:exploring the role of hospital-wide education committees[J].BMC Med Educ,2017,17(1):241.
[9] 中华人民共和国国家卫生与计划生育委员会.消毒技术规范[S].2002:2-7.
[10] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[11] 尚红,王毓三,申子瑜.全国临床检验操作规程[M].北京:人民卫生出版社,2015:149-195.
[12] 中华人民共和国卫生部.医院感染管理规范(试行)[S].1994:2-3.
[13] 上海市消毒品协会.医院消毒技术规范[M].北京:中国标准出版社,2008:214.
[14] 中华人民共和国国家标准化管理委员会.医院消毒卫生标准(GB 15982-1995)[S].1995:3-5.
[15] Woo KS,Choi JL,Kim BR,et al.Outbreak of Pseudomonas oryzihabitans pseudobacteremia related to contaminated equipmentin an emergency room of a tertiary hospital in Korea[J].nfect Chemother,2014,46(1):42-44.
[16] Stalenhoef JE,van Dissel JT,van Nieuwkoop C.Febrile urinary tract infection in the emergency room[J].Curr Opin Infect Dis,2015,28(1):106-111.
[17] Dasgupta S,Das S,Chawan NS,et al.Nosocomial infections in the intensive care unit:Incidence,risk factors,outcome and associated pathogens in a public tertiary teaching hospital of Eastern India[J].Indian J Crit Care Med,2015,19(1):14-20.
[18] 刘玲,李春梅,杨晓丽,等.PDCA循环在提高医院感染管理质量中的效果分析[J].中华医院感染学杂志,2017,27(3):685-687.
[19] Arntz PR,Hopman J,Nillesen M,et al.Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department[J].Am J Infect Control,2016,44(11):1203-1207.
[20] Ho JD,Ansari RK,Page D.Hand sanitization rates in an urban emergency medical services system[J].J Emerg Med,2014,47(2):163-168.
[21] 邵晓红,韩德辉,刘颖,等.应用PDCA法控制门诊医院感染的研究[J].中华医院感染学杂志,2016,26(5):1183-1185.
[22] 李妍,崔凤英.PDCA循环法在急诊科护理安全管理中的应用[J].河北医药,2015,37(19):3017-3019.