儿童先天性心脏病在基于PDCA循环的手术室感染控制分析
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摘要
目的分析儿童先天性心脏病在基于PDCA [计划(Plan)、实施(Do)、检查(Check)、行动(Action)]循环的手术室感染控制效果,以期为儿童先天性心脏病手术室感染的防治提供参考依据。方法纳入分析2016年1月-2017年6月在上海交通大学附属上海儿童医学中心行手术治疗的393例先天性心脏病患儿按照管理方式分为观察组202例和对照组191例,观察组患儿给予PDCA循环管理,对照组患儿给予常规管理。观察并比较两组患儿病原菌检查率、手术切口感染率、体温升高率、WBC升高率及消毒合格率。结果观察组患儿病原菌检出率6. 93%低于对照组患儿的17. 28%,差异有统计学意义(P<0. 01)。观察组患儿手术切口感染率0. 99%、体温升高率2. 97%及WBC升高率1. 49%均低于对照组患儿的6. 28%、11. 52%及7. 85%,差异有统计学意义(P <0. 05)。观察组患儿有关治疗环境的消毒合格率其医护人员手部为88. 12%、物体表面为90. 10%、室内空气为85. 15%及手术室恒温箱为48. 02%均明显高于对照组的61. 78%、63. 35%、63. 87%及9. 95%,差异有统计学意义(P<0. 05)。结论 PDCA循环管理模式可有效控制儿童先天性心脏病手术室感染,减少病原菌产生,提高手术室消毒效果,值得临床广泛推广。
Objective To analyze the effect of operating room infection control of childhood congenital heart disease based on PDCA( plan,do,check,action) cycle,provide a reference basis for prevent and treat operating room infection of childhood congenital heart disease. Methods A total of 393 children with congenital heart disease treated by surgery in Shanghai Children's Medical Center from January2016 to June 2017 were selected and divided into observation group( 202 children) and control group( 191 children) according to management mode. The children in observation group were given PDCA cycle management,and the children in control group were given routine management. The pathogen detection rates,surgical incision infection rates,fervescence rates,leukocytosis rates,and eligible rates of disinfection were observed and compared between the two groups. Results The pathogen detection rate in observation group was 6. 93%,which was statistically significantly lower than that in control group( 17. 28%)( P<0. 01). The surgical incision infection rate,fervescence rate,and leukocytosis rate in observation group were 0. 99%,2. 97%,and 1. 49%,respectively,which were statistically significantly lower than those in control group( 6. 28%,11. 52%,7. 85%)( P< 0. 05). The eligible rates of disinfection of hands,surgical instruments,indoor air,and operating room incubator in observation group were 88. 12%,90. 10%,85. 15%,and 48. 02%,respectively,which were statistically significantly higher than those in control group( 61. 78%,63. 35%,63. 87%,and 9. 95%)( P < 0. 05). Conclusion PDCA cycle management mode can effectively control operating room infection of children with congenital heart disease,reduce the generation of pathogenic bacteria,and improve disinfection effect of operating room,which is worthy of widespread clinical promotion.
Objective To analyze the effect of operating room infection control of childhood congenital heart disease based on PDCA( plan,do,check,action) cycle,provide a reference basis for prevent and treat operating room infection of childhood congenital heart disease. Methods A total of 393 children with congenital heart disease treated by surgery in Shanghai Children's Medical Center from January2016 to June 2017 were selected and divided into observation group( 202 children) and control group( 191 children) according to management mode. The children in observation group were given PDCA cycle management,and the children in control group were given routine management. The pathogen detection rates,surgical incision infection rates,fervescence rates,leukocytosis rates,and eligible rates of disinfection were observed and compared between the two groups. Results The pathogen detection rate in observation group was 6. 93%,which was statistically significantly lower than that in control group( 17. 28%)( P<0. 01). The surgical incision infection rate,fervescence rate,and leukocytosis rate in observation group were 0. 99%,2. 97%,and 1. 49%,respectively,which were statistically significantly lower than those in control group( 6. 28%,11. 52%,7. 85%)( P< 0. 05). The eligible rates of disinfection of hands,surgical instruments,indoor air,and operating room incubator in observation group were 88. 12%,90. 10%,85. 15%,and 48. 02%,respectively,which were statistically significantly higher than those in control group( 61. 78%,63. 35%,63. 87%,and 9. 95%)( P < 0. 05). Conclusion PDCA cycle management mode can effectively control operating room infection of children with congenital heart disease,reduce the generation of pathogenic bacteria,and improve disinfection effect of operating room,which is worthy of widespread clinical promotion.
引文
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[8]梁改红.PDCA循环管理在手术室医院感染预防控制中的应用效果[J].河南医学研究,2017,26(19):3618-3619.
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[10]郑洁.PDCA循环法在手术室护理质量管理中的应用研究[J].中国卫生产业,2017,14(21):3-5.
[11]Cai J.PDCA model for management of prevention and control of hospital infection in operating room[J].Chinese J Nosocomiol,2012,22(5):1003-1005.
[12]Gon9alves P,Kawagoe JY,Cardoso M,et al.PDCA cycle reports:a quality tool to improve physician hand hygiene compliance[J].Antimicrob Resistan Infect Cont,2015,4(S1):1.
[2]汪婷婷.PDCA循环对手术室感染控制的效果[J].中医药管理杂志,2016,(13):166-168.
[3]叶蕾.PDCA模式在手术室医院感染的预防与控制中的应用[J].中医药管理杂志,2016,(19):89-91.
[4]陈瑞洁.PDCA循环管理模式对手术室感染控制的效果观察[J].河南医学研究,2016,25(4):764-764.
[5]Liu X,Fang SZ,Gao XP,et al.Application of PDCA cycle and fine management in control of nosocomial infections in the eye wards[J].Chinese J Nosocomiol,2013,23(12):2957-2958.
[6]邹彦,陆雪飞,朱秀峰.PDCA循环对手术室感染控制管理效果分析[J].中华医院感染学杂志,2015,25(9):2145-2147.
[7]何春艳,刘红,向文娟,等.PDCA循环管理法在手术室护理安全与质量改进中的应用效果分析[J].实用临床医药杂志,2017,21(16):106-108.
[8]梁改红.PDCA循环管理在手术室医院感染预防控制中的应用效果[J].河南医学研究,2017,26(19):3618-3619.
[9]吴菊花.PDCA循环法在手术室感染管理的应用效果[J].职业卫生与病伤,2015,30(6):365-367.
[10]郑洁.PDCA循环法在手术室护理质量管理中的应用研究[J].中国卫生产业,2017,14(21):3-5.
[11]Cai J.PDCA model for management of prevention and control of hospital infection in operating room[J].Chinese J Nosocomiol,2012,22(5):1003-1005.
[12]Gon9alves P,Kawagoe JY,Cardoso M,et al.PDCA cycle reports:a quality tool to improve physician hand hygiene compliance[J].Antimicrob Resistan Infect Cont,2015,4(S1):1.