基于PDCA循环改进肿瘤专科医院术后统计方法
|
摘要
目的探讨PDCA循环法用于改进手术后肺炎统计管理的效果,以提高统计的准确性,使这项指标真实有效反映手术后并发症的发生情况。方法应用SQL Server 2000收集2012年1月—2016年6月期间住院患者相关信息,利用R语言工具统计每年手术后肺炎的发生率,采用PDCA循环改进手术后肺炎的统计方法,比较干预前后的差异。结果通过运用PDCA循环,查找分析手术后肺炎统计过程中的问题,发现某些非手术后肺炎的病例由于诊断填写及编码的问题,被误判为手术后肺炎,导致统计误差,通过采取改进措施,使误差率由35.80%下降为0,干预前后差异有统计学意义。结论 PDCA循环应用于手术后肺炎的统计管理,改进效果明显,提高手术后肺炎统计的准确性。
Objective To discuss the effect of PDCA circulation method on improving the statistical management of postoperative pneumonia and the accuracy of statistics so that this index would accurately and effectively reflect postoperative complications. Methods Relative information of patients from January 2012 to June 2016 was collected using SQL Server 2000. The annual incidence of pneumonia after surgery was calculated using R Language. The statistical method of analyzing pneumonia after surgery was improved by PDCA circulation to determine the differences before and after the intervention. Results This study found and analyzed the following problems in the statistical analysis of postoperative pneumonia: some non-operative types of pneumonia were mistaken as postoperative pneumonia due to the diagnosis and coding problems,which led to statistical errors. The measures taken in the study reduced the error rate from 35. 80% to 0. The difference of pre-intervention and post-intervention was statistically significant. Conclusion Statistical management of PDCA circulation in postoperative pneumonia significantly improves the result and the accuracy of statistical indicators.
Objective To discuss the effect of PDCA circulation method on improving the statistical management of postoperative pneumonia and the accuracy of statistics so that this index would accurately and effectively reflect postoperative complications. Methods Relative information of patients from January 2012 to June 2016 was collected using SQL Server 2000. The annual incidence of pneumonia after surgery was calculated using R Language. The statistical method of analyzing pneumonia after surgery was improved by PDCA circulation to determine the differences before and after the intervention. Results This study found and analyzed the following problems in the statistical analysis of postoperative pneumonia: some non-operative types of pneumonia were mistaken as postoperative pneumonia due to the diagnosis and coding problems,which led to statistical errors. The measures taken in the study reduced the error rate from 35. 80% to 0. The difference of pre-intervention and post-intervention was statistically significant. Conclusion Statistical management of PDCA circulation in postoperative pneumonia significantly improves the result and the accuracy of statistical indicators.
引文
[1]中华人民共和国卫生部.医院感染诊断标准[S].2001-01-02.
[2]Trinh VQ,Ravi P,Abd-El-Barr AE,et al.Pneumonia after Major Cancer Surgery:Temporal Trends and Patterns of Care[J].Canadian Respiratory Journal,2016(7):1-7.
[3]A.Andalib,A.V.Ramana-Kumar,G.Bartlett,E.L.et al.Influence of postoperative infectious complications on long-term survival of lung cancerpatients:a population-based cohort study[J].Thoracic Oncology,2013(8):554-561.
[4]G.Pei,S.Zhou,Y.Han,Z.et al.Risk factors for postoperative complications after lung resection for non-small cell lung cancer in elderly patients at a single institution in China[J].Journal of Thoracic Disease,2014(6):1230-1238.
[5]Dennis F.Simonsen,Mette Sgaard,Imre Bozi.Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival[J].Respiatory medicine,2015,109(10):1340-1346.
[6]《应用抗菌药物防治外科感染的指导意见》撰写协作组.应用抗菌药物防治外科感染的指导意见XXI-手术后肺炎[J].中华外科杂志,2005,43(17):1158-1160.
[7]Division of Healthcare Quality Promotion National Center for Infectious Diseases Atlanta,GA,USA.The National Healthcare Safety Network(NHSN)Manual PATIENT SAFETY COMPONENT PROTOCOL[EB/OL].www.cdc.gov
[2]Trinh VQ,Ravi P,Abd-El-Barr AE,et al.Pneumonia after Major Cancer Surgery:Temporal Trends and Patterns of Care[J].Canadian Respiratory Journal,2016(7):1-7.
[3]A.Andalib,A.V.Ramana-Kumar,G.Bartlett,E.L.et al.Influence of postoperative infectious complications on long-term survival of lung cancerpatients:a population-based cohort study[J].Thoracic Oncology,2013(8):554-561.
[4]G.Pei,S.Zhou,Y.Han,Z.et al.Risk factors for postoperative complications after lung resection for non-small cell lung cancer in elderly patients at a single institution in China[J].Journal of Thoracic Disease,2014(6):1230-1238.
[5]Dennis F.Simonsen,Mette Sgaard,Imre Bozi.Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival[J].Respiatory medicine,2015,109(10):1340-1346.
[6]《应用抗菌药物防治外科感染的指导意见》撰写协作组.应用抗菌药物防治外科感染的指导意见XXI-手术后肺炎[J].中华外科杂志,2005,43(17):1158-1160.
[7]Division of Healthcare Quality Promotion National Center for Infectious Diseases Atlanta,GA,USA.The National Healthcare Safety Network(NHSN)Manual PATIENT SAFETY COMPONENT PROTOCOL[EB/OL].www.cdc.gov