运用PDCA循环提高医学影像科感染控制效果的研究

Study on improvement of the effect of infection control in radiology department using PDCA circulation

目的探讨PDCA循环法用于规范医学影像科感染控制制度和流程,以不断提高感染控制效果。方法应用3次PDCA循环管理对80名医学影像科工作人员(其中有5名护理人员)进行手卫生、医疗废物处理、室内空气消毒考核和问卷调查,静脉穿刺无菌操作(仅对护士)的考核和问卷调查,并比较实施PDCA前后在上述几个方面的考核效果。结果实施PDCA前后医务人员对洗手指征掌握、洗手步骤实施以及手细菌培养的合格率分别为38.75%和87.50%、50.00%和93.75%、76.25%和97.50%,前后比较差异均具有统计学意义(P<0.001);实施PDCA前后医务人员对常见医疗废物分类和医疗废物收集要求掌握的合格率分别为20.00%和86.25%、46.25%和88.75%,前后比较差异均具有统计学意义(P<0.001);科室室内空气消毒合格率由实施PDCA前的68.18%提高到实施PDCA后的95.45%,差异均具有统计学意义(P=0.019);护士静脉穿刺无菌操作合格率由实施PDCA前的80.00%提高到实施PDCA后的98.00%,差异具有统计学意义(P<0.001)。结论采用PDCA循环法可有效提高医学影像科感染的控制效果。

Objective To estimate the value of PDCA circulation method in standardizing and improving the effect of infection control in radiology department.Methods 80 medical staffs（including five nurses）from the department of diagnostic radiology were assessed and conducted a questionnaire survey about hand hygiene,medical waste disposal,indoor air disinfection and venipuncture aseptic operation（only for nurses）by three times PDCA circle.Assessment results of the above four indicators were compared before and after the implementation of PDCA.Results The participant＇s qualification rate of hands washing indication,standard and bacterial culture before and after performing PDCA were 38.75% and 87.50%,50.00% and 93.75%,76.25% and 97.50%,respectively.The significant difference was found between before and after the implementation of PDCA（P〈0.001）.Moreover,the participant＇s rate of mastery about common medical waste classification and medical waste collection requirements before and after performing PDCA were 20.00% and 86.25%,46.25% and 88.75%,respectively.There was also a significant difference between before and after the implementation of PDCA（P〈0.001）.The qualification rate of indoor air disinfection increased from 68.18% to 95.45% after PDCA was implemented,with a significant difference（P =0.019）.The qualification rate of nurse aseptic venipuncture operation increased from80.00%to 98.00% after PDCA was implemented,also with a significant difference（P〈0.001）.Conclusion The performance of PDCA circulation can effectively improve the effect of infection control in the radiology department.