运用PDCA循环提高医务人员手卫生依从性
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摘要
目的观察运用PDCA(plan-do-check-action)循环提高医务人员手卫生依从性效果。方法以河南省人民医院各临床医技科室医务人员为此次调查对象,自2018年1月1日～2018年5月5日对所有人的手卫生依从性进行全面的调查和PDCA持续改进,观察其实施效果。结果 2018年1～2月(实施前)手卫生依从性为20.01%;2018年3～4月(实施后第一次调查)与2018年5月(实施后第二次调查),手卫生依从性分别为48.10%和57.86%,实施PDCA循环管理后医务人员手卫生依从性逐渐上升;医生、护理人员、实习生、进修生及研究生的手卫生依从性较实施前升高,差异均有统计学意义(P<0.01),但保洁及护工人员手卫生依从性较差,且PDCA循环管理实施前后无明显改变(P>0.05);医务人员在接触患者前、无菌操作前、接触血液体液后、接触患者后、接触周围物品后的手卫生依从性较实施前升高,差异均有统计学意义(P<0.01)。结论运用PDCA循环提高医务人员手卫生依从性效果显著,值得推广实施。
Objective To observe the improvement effects of PDCA(plan-do-check-action) cycle mode in the medical staff's compliance on the hand hygiene. Methods From January 1, 2018 to May 5, 2018, the medical staff worked in the Medical Laboratory Department of Henan Provincial People's Hospital received the comprehensive survey on their hand hygiene and the continuous improvements with PDCA cycle mode. The management effect was probed. Results From January to February 2018(before management), the medical staff's compliance on the hand hygiene was 20.01 %;from March to April 2018(first survey after management) and in May 2018(second survey after management), their compliance on the hand hygiene was 48.10 % and 57.86 %, respectively. After management, the medical staff's compliance on the hand hygiene was gradually increased; after management, the doctor, nurse, intern student, advanced student and postgraduate had the higher compliance on the hand hygiene(P<0.01); but the cleaner and nursing worker had the poorer compliance on the hand hygiene, without significant difference before and after management(P>0.05);the medical staff had the higher compliance on the hygiene before making contact with patients and sterile operation,and after making contact with the blood and body fluid, patients and things around the environment(P<0.01).Conclusions The PDCA cycle mode can remarkably improve the medical staff's compliance on the hand hygiene. It is worthy of clinical promotion and application.
Objective To observe the improvement effects of PDCA(plan-do-check-action) cycle mode in the medical staff's compliance on the hand hygiene. Methods From January 1, 2018 to May 5, 2018, the medical staff worked in the Medical Laboratory Department of Henan Provincial People's Hospital received the comprehensive survey on their hand hygiene and the continuous improvements with PDCA cycle mode. The management effect was probed. Results From January to February 2018(before management), the medical staff's compliance on the hand hygiene was 20.01 %;from March to April 2018(first survey after management) and in May 2018(second survey after management), their compliance on the hand hygiene was 48.10 % and 57.86 %, respectively. After management, the medical staff's compliance on the hand hygiene was gradually increased; after management, the doctor, nurse, intern student, advanced student and postgraduate had the higher compliance on the hand hygiene(P<0.01); but the cleaner and nursing worker had the poorer compliance on the hand hygiene, without significant difference before and after management(P>0.05);the medical staff had the higher compliance on the hygiene before making contact with patients and sterile operation,and after making contact with the blood and body fluid, patients and things around the environment(P<0.01).Conclusions The PDCA cycle mode can remarkably improve the medical staff's compliance on the hand hygiene. It is worthy of clinical promotion and application.
引文
[1]戴玉芳,周健,彭美玲等.运用PDCA循环持续提高医务人员手卫生依从性[J].中国感染控制杂志,2014,13(10):616-618.
[2] Wearn, Andy,Bhoopatkar, Harsh,Nakatsuji, Miriam et al.Evaluation of the effect of hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center[J].Journal of infection and public health,2015,8(5):425-431.
[3]张晓丽,吴玉梅,林林,等.PDCA管理模式在NICU医护人员手卫生中的应用及效果评价[J].中国消毒学杂志,2014,31(12):1369-1370.
[4] Srigley J A,Gardam M,Fernie G,et al.Hand hygiene monitoring technology:a systematic review of efficacy[J].The Journal of hospital infection,2015,89(1):51-60.
[5]刘建明,陈雪霞,谭智,等.FOCUS-PDCA循环管理对提高医务人员手卫生依从性的效果分析[J].中国医疗管理科学,2016,6(4):27-31.
[6]王秀娟.PDCA循环法在传染科医务人员手卫生管理中的作用[J].中国消毒学杂志,2013,30(1):88-89.
[7] Hong Tracey S,Bush Emily C,Hauenstein Morgan F,et al.A Hand Hygiene Compliance Check System:Brief Communication on a System to Improve Hand Hygiene Compliance in Hospitals and Reduce Infection[J].Journal of medical systems,2015,39(6):69-72.
[8] Salmon S,Pittet D,Sax H,et al.The'My five moments for hand hygiene'concept for the overcrowded setting in resource-limited healthcare systems[J].The Journal of hospital infection,2015,91(2):95-99.
[9]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.
[2] Wearn, Andy,Bhoopatkar, Harsh,Nakatsuji, Miriam et al.Evaluation of the effect of hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center[J].Journal of infection and public health,2015,8(5):425-431.
[3]张晓丽,吴玉梅,林林,等.PDCA管理模式在NICU医护人员手卫生中的应用及效果评价[J].中国消毒学杂志,2014,31(12):1369-1370.
[4] Srigley J A,Gardam M,Fernie G,et al.Hand hygiene monitoring technology:a systematic review of efficacy[J].The Journal of hospital infection,2015,89(1):51-60.
[5]刘建明,陈雪霞,谭智,等.FOCUS-PDCA循环管理对提高医务人员手卫生依从性的效果分析[J].中国医疗管理科学,2016,6(4):27-31.
[6]王秀娟.PDCA循环法在传染科医务人员手卫生管理中的作用[J].中国消毒学杂志,2013,30(1):88-89.
[7] Hong Tracey S,Bush Emily C,Hauenstein Morgan F,et al.A Hand Hygiene Compliance Check System:Brief Communication on a System to Improve Hand Hygiene Compliance in Hospitals and Reduce Infection[J].Journal of medical systems,2015,39(6):69-72.
[8] Salmon S,Pittet D,Sax H,et al.The'My five moments for hand hygiene'concept for the overcrowded setting in resource-limited healthcare systems[J].The Journal of hospital infection,2015,91(2):95-99.
[9]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.