PDCA循环与量化考核在医院感染管理应用中的效果比较

Effects of PDCA cycle and quantitative assessment on control of nosocomial infections:a comparative study

目的比较PDCA循环与量化考核在医院感染管理中应用效果,探讨有效管理措施。方法将2012年2月-2013年2月实施PDCA循环圈后临床科室的70 748例患者数据归为研究组,2011年1月-2012年1月,实施处理量化考核后的69 576例患者数据归为对照组,比较两组医院感染率及抗菌药物使用情况,所有数据采用SPSS15.0软件进行数据统计。结果研究组70 748例患者发生医院感染2 278例,感染率3.22%;对照组69 576例患者发生医院感染3 194例,感染率4.59%,两组比较差异有统计学意义(P<0.05);与对照组比较,研究组的抗菌药物合计使用例次、合计使用天数、平均使用时间均下降明显,差异有统计学意义(P<0.05),联合用药情况中,单一用药频次增加,≥2种的用药频次下降,使用途径中雾化吸入频次下降,差异均有统计学意义(P<0.05);研究组DUI值平均为0.80±0.07,对照组为1.02±0.04,研究组优于对照组,差异有统计学意义(P<0.05)。结论在医院感染管理中应用PDCA循环,可有效降低医院感染率,使抗菌药物使用更趋于合理。

OBJECTIVE To compare the effects of the PDCA cycle and quantitative assessment on control of nosocomial infections and explore effective management measures. METHODS The data of 70 748 patients in the clinical medical departments where the PDCA cycle was carried out from Feb 2012 to Feb 2013 were assigned as the study group, and the data of 69 576 patients in the clinical medical departments where the quantitative assessment was implemented from Jan 2011 to Jan 2012 were set as the control group; the incidence of nosocomial infections and the use of antibiotics were observed and compared between the two groups, and all the data were statistically analyzed with the use of SPSS15.0 software. RESULTS The nosocomial infections occurred in 2 278 of 70 748 patients in the observation group, with the infection rate of 3.22% ; the nosocomial infections occurred in 3 194 of 69 576 patients in the control group, with the infection rate of 4.59%, and there was significant difference （P〈0.05）. The difference in the total case-times of use of antibiotics, total duration, or average time of use of antibiotics between the control group and the observation group was significant （P〈0.05）. As compared with the combination use of antibiotics, the frequency of use of single antibiotic was increased, the frequency of use of multiple antibiotics more than 2 types was decreased, the frequency of aerosol inhalation in use pathway was decreased, and there was significant difference （P〈0.05）. The median DUI value was 0.80±0.07 in the study group, better than 1.02 ±0.04 in the control group, and there was significant difference （P〈0.05）. CONCLUSION The application of PDCA cycle in the control of nosocomial infections can effectively reduce the incidence of nosocomial infections and promote the reasonable use of antibiotics.