医药护合作品管圈活动预防中心静脉导管相关性感染的效果观察
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摘要
目的探讨医药护合作品管圈(quality control circle,QCC)活动在预防重症监护室(ICU)患者中心静脉导管相关性感染(catheter related blood stream infection,CRBSI)中的作用及效果。方法由科室5名临床医师、1名临床药师及6名护士成立QCC小组,开展以"规范中心静脉导管(central venus catheter,CVC)的建立与维护,降低CRBSI发生率"为主题的品管圈活动。选择2015年1月至10月置有CVC的患者313例为对照组(活动前),2016年1月至10月置有CVC的患者342例为观察组(活动后),按QCC活动步骤,运用PDCA方法,管理置有CVC的患者,并比较活动前后CRBSI的发生率。结果 CRBSI发生率从活动前的5.25‰降至活动后的0.74‰,差异有统计学意义(P<0.01)。结论医药护合作QCC活动,可全面评估患者情况,提高了CRBSI预防措施在CVC维护中的落实率,CRBSI发生率明显下降,且提高了圈员的综合能力,明显增强了团队精神。
Objective To investigate the effect of quality control circle( QCC) activities in prevention and treatment of intensive care unit( ICU) patients with catheter related blood stream infection( CRBSI). Methods A QCC group was set up by 5 clinicians,1 clinical pharmacist and 6 nurses to carry out the quality control system with the theme of ″establishing and maintaining the central venus catheter( CVC) and reducing the incidence of CRBSI″ activity. The 313 patients who had CVC were enrolled in the department were selected as the control group( before the event) from January to October in 2015. The 342 patients who had CVC were enrolled in the department were selected as the observation group( after the event) from January to October in 2016. According to the QCC activity procedure,PDCA was used to manage the patients with CVC and to compare the incidence of CRBSI before and after the event.Results The incidence of CRBSI decreased from 5. 25 ‰ before activity to 0. 748 ‰ after activity,the difference between the two groups was statistically significant( P < 0. 01). Conclusion The QCC activities are carried out to assess the condition of patients comprehensively and improve the implementation rate of prevention of catheter-related infection in CVC maintenance. The incidence of CRBSI is significantly decreased,and the comprehensive ability and spirit of the team is improved.
Objective To investigate the effect of quality control circle( QCC) activities in prevention and treatment of intensive care unit( ICU) patients with catheter related blood stream infection( CRBSI). Methods A QCC group was set up by 5 clinicians,1 clinical pharmacist and 6 nurses to carry out the quality control system with the theme of ″establishing and maintaining the central venus catheter( CVC) and reducing the incidence of CRBSI″ activity. The 313 patients who had CVC were enrolled in the department were selected as the control group( before the event) from January to October in 2015. The 342 patients who had CVC were enrolled in the department were selected as the observation group( after the event) from January to October in 2016. According to the QCC activity procedure,PDCA was used to manage the patients with CVC and to compare the incidence of CRBSI before and after the event.Results The incidence of CRBSI decreased from 5. 25 ‰ before activity to 0. 748 ‰ after activity,the difference between the two groups was statistically significant( P < 0. 01). Conclusion The QCC activities are carried out to assess the condition of patients comprehensively and improve the implementation rate of prevention of catheter-related infection in CVC maintenance. The incidence of CRBSI is significantly decreased,and the comprehensive ability and spirit of the team is improved.
引文
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[13]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
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[15]朱水龙.重症监护室多重耐药菌的耐药性检测分析[J].中国药业,2012,21(22):48-49.
[16]周铭红.品管圈活动用于手术室药品管理实践及体会[J].中国药业,2015,24(24):168-170.
[2]高俊扬,刘庭芳.我国医院品管圈真因验证存在的问题及其对策[J].中国医院,2015,19(7):7-9.
[3]周蓓.品管圈在降低ICU中心静脉置管非计划性拔管中的应用[J].中华全科医学,2015,13(9):1537-1540.
[4]黄幼平.ICU设立品管圈活动小组的适用性分析[J].现代医学,2014,42(1):96-99.
[5]黄丽玉,赵丽霞,戴小明,等.品管圈活动在ICU多重耐药菌病人护理管理中的应用[J].护理研究,2014,28(11):3916-3918.
[6]万玉英,韩小建.PDCA循环加强ICU医务人员手卫生管理对控制MRSA医院感染的影响[J].重庆医学,2015,44(34):4777-4779.
[7]郭广芹,周文静,李淑真.PDCA循环管理法在医务人员手卫生依从性中的应用[J].护理实践与研究,2015,12(5):103-104.
[8]於芹.PDCA循环管理模式在ICU患者管道安全护理中的应用[J].中西医结合护理(中英文),2016,2(7):83-87.
[9]王艳,杨阳,陈佳佳.头脑风暴法在优质护理服务示范工程中的应用分析[J].河南医学研究,2016,25(6):1139-1140.
[10]程念开.二八定律在ICU护理质量分组控制中的应用[J].齐鲁护理杂志,2013,19(4):108-109.
[11]吴春娇.护理管理工作中“二八”定律的应用[J].中医药管理杂志,2015,23(3):159-160.
[12]巩越丽,秦艳玲,袁梅.“二八”法则延伸至护理管理中有效规避护理不安全隐患[J].中国实用医药,2013,8(30):263-264.
[13]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[14]李晨,刘志忠,谢家兴,等.PDCA循环质量管理模式控制康复医院多重耐药菌感染的效果[J].中国康复理论与实践,2016,22(12):1476-1479.
[15]朱水龙.重症监护室多重耐药菌的耐药性检测分析[J].中国药业,2012,21(22):48-49.
[16]周铭红.品管圈活动用于手术室药品管理实践及体会[J].中国药业,2015,24(24):168-170.