基于FOCUS-PDCA的院感质控管理措施对环境卫生学消毒效果和手卫生的影响

Influence of hospital quality control management measures based on FOCUS-PDCA on environmental hygiene disinfection effect and hand hygiene

目的探讨基于寻找、组织、澄清、理解、计划、实操、检查、执行(FOCUS-PDCA)模式的院感质控管理措施在基层医院院内环境卫生学消毒效果和手卫生中的应用效果。方法浙江省杭州市西溪医院于2021年1月开始应用基于FOCUS-PDCA的院感质控管理措施对院感防控工作进行管理,选取新质控管理措施应用前的2020年1月至12月作为对照时段,选取新质控管理措施应用后的2021年1至12月作为观察时段。同时分别选取院内各科室医护人员共80名纳入研究。比较FOCUS-PDCA实施前后院内消毒卫生监测情况,同时比较院内医护人员的感控知识评分、卫生消毒技能评分及医护人员手卫生执行合格状况。结果FOCUS-PDCA实施后,院内环境样本的检测总合格率高于实施前,差异有统计学意义(P<0.05)。FOCUS-PDCA实施后,院内医护人员的感控知识及卫生消毒技能评分均高于实施前,差异有统计学意义(P<0.05)。FOCUS-PDCA实施后,院内医护人员在接触患者前、无菌操作前、风险操作后、接触患者后手卫生合格率均高于实施前,差异有统计学意义(P<0.05)。结论基于FOCUS-PDCA的院感质控管理措施能够显著提升院感防控中环境卫生的消毒质量,提升医护人员对手卫生及院感防控的执行意识,促进院内感染防控工作的规范化。

Objective To investigate the application effect of hospital quality control management measures based on find-organize-clarify-understand-select-plan-do-check-act(FOCUS-PDCA)model on the disinfection effect of environmental hygiene and hand hygiene in primary hospitals.Methods In January 2021,Xixi Hospital in Hangzhou began to apply the quality control management measures based on FOCUS-PDCA to manage the prevention and control of hospital infection.The period from January to December 2020 before the application of the new quality control management measures was selected as the control period,and the period from January to December 2021 after the application of the new quality control management measures was selected as the observation period.At the same time,a total of 80 medical staff from various departments in the hospital were selected for inclusion in the study.The monitoring of disinfection and hygiene in the hospital before and after the implementation of FOCUS-PDCA were compared.At the same time,the scores of infection control knowledge,hygiene,and disinfection skills of medical staff in the hospital and the qualified status of hand hygiene of medical staff were compared.Results After the implementation of FOCUS-PDCA,the test pass rate of the in-hospital environmental samples was higher than that before the implementation,and the difference was statistically significant(P<0.05).After the implementation of FOCUS-PDCA,the scores of infection control knowledge and sanitation and disinfection skills of the medical staff in the hospital were higher than those before the implementation,and the differences were statistically significant(P<0.05).The qualified rate of hand hygiene of medical staff in the hospital before contact with patients,before aseptic operation,after risky operation,and after contact with patients were higher than that before implementation,and the differences were statistically significant(P<0.05).Conclusion The hospital infection quality control management measures based on FOCUS-PDCA can significantly improve the disinfection effect of environmental hygiene in the prevention and control of hospital infection,enhance the awareness of hand hygiene and the implementation of hospital infection prevention and control among medical staff,and promote the standardization of nosocomial infection prevention and control.