精细化管理在静脉药物集中调配中心感染控制管理中的应用

Infection control; Fine management; Pharmacy intravenous admixture services; Average number of colonies; Hand hygieneApplication of fine management in the infection control and management of pharmacy intravenous admixture services

目的研究精细化管理在静脉药物集中调配中心感染控制管理中的作用及效果评价。方法回顾性分析静脉药物集中调配中心2013年7月至2016年6月的感染控制管理，其中2013年7月至2014年12月为常规管理，2015年1月至2016年6月为精细化管理。比较精细化管理前后静脉药物集中调配中心洁净区空气沉降菌生成率、药护人员手卫生依从性、正确率、工作人员手菌落数监测的数据。结果实施精细化管理后，洁净区空气沉降菌生成率从10.42%（120.0/1 152）降到4.45%（51.3/1 152），差异有统计学意义（χ2=3.417，P〈0.01）；药护人员手卫生依从性从81.50%（1 172/1 438）提高到95.56%（1 314/1 375），差异有统计学意义（χ2=1.353，P〈0.01）；正确率从86.09%（1 009/1 172）提高到95.13%（1 250/1 314），差异有统计学意义（χ2=60.975，P〈0.01）；精细化管理后工作人员手菌落数监测较前有所下降，差异有统计学意义（χ2=41.163，P〈0.01）。 结论 精细化管理在静脉药物集中调配中心感染控制管理中有着较高的应用价值，可降低洁净区空气沉降菌生成率，工作人员手菌落数，提高药护人员手卫生依从性和正确率，进一步规范了工作人员的行为，提供了更安全的配制环境，保证药物配制的质量。

To investigate the fine management in the role of infection control management and the effect evaluation in pharmacy intravenous admixture services.MethodsFrom July 2013 to June 2016, infection control management were reviewed retrospectively in pharmacy intravenous admixture services： routine management （from July 2013 to December 2014） and fine management （from January 2015 to June 2016）. The settlement of air bacteria formation rate, hand hygiene compliance and accuracy of drug-care workers, and worker′s hand colonization monitoring data before and after the fine management were compared.Results After the implementation of fine management, the settlement of air bacteria formation rate was reduced from 10.42% （120.0/1 152） to 4.45% （51.3/1 152）; there was significant differences （t=3.417, P〈0.01）.The hand hygiene compliance of drug-care workers increased from 81.50%（1 172/1 438） to 95.56%（1 314/1 375）, the difference was statistically significant （χ2= 1.353, P〈0.01）; the accuracy rate increased from 86.09%（1 109/1 172） to 95.13%（1 250/1 314）, the difference was statistically significant （χ2=60.975, P〈0.01）; workers′ hands colonies number after fine management decreased than before, and there was significant differences （χ2=41.163, P〈0.01）.ConclusionsThe fine management has a higher application value in the infection control management of pharmacy intravenous admixture services, which can reduce the settlement of air bacteria formation rate, workers′ hands colonies number, improve hand hygiene compliance and accuracy of drug-care workers, further standardize the worker′s behavior, provide a more secure configuration environment, and guarantee the quality of drug configuration.