PDCA循环在提高医务人员手卫生依从性中的作用

Role of PDCA cycle in improving hand hygiene compliance of medical staff

目的通过持续质量改进的实施与效果评价,提高全院医务人员手卫生依从性。方法应用计划-实施-检查-处理(PDCA)循环即管理循环模进行持续质量改进,加强全员培训,注重过程管理,强调规范洗手,定期检查和随机抽查相结合。结果实施PDCA循环后,医务人员的手卫生知识考试成绩优秀率由20.00%升至68.00%,差异有统计学意义(χ2=46.753,P<0.01);医务人员接触患者前手卫生洗手率由实施前的16.67%升至实施后的75.20%,接触患者后洗手率由34.48%升至92.86%,脱手套后洗手率由25.00%升至91.87%,差异均有统计学意义(P<0.01)。结论医务人员的手卫生是预防医院感染的主要措施之一,应用PDCA循环进行持续质量改进,可有效提高医务人员手卫生意识及其依从性。

OBJECTIVE To improve the hand hygiene compliance of all medical staff by the implementation of the continuous quality improvement and assessment of effect.METHODS The continuous quality improvement was performed by using PDCA cycle including strengthening all-staff-training,emphasizing process management and periodical inspection with random sampling.RESULTS After the implementation of PDCA cycle,the excellence rate of the the medical staff’s awareness about the hand hygiene raised from 20.00% to 68.00%,the difference was statistically significant（χ2= 46.753,P〈0.01）;the rate of washing hands before contacting the patients increased from the 16.67% before the implementation to 75.20% after the implementation,increasing from 34.48% to 92.86% after contacting the patients,and increasing from 25.00% to 91.87% after removing the gloves,the differences were statistically significant（P〈0.01）.CONCLUSIONS The hand hygiene of the medical staff is one of the most critical way to prevent nosocomial infections,the application of PDCA cycle for the continuous quality improvement can effectively improve the awareness of the hand hygiene as well as its compliance.