基于PDCA循环管理模式的手术室感染控制在泌尿外科腔镜手术患者护理中的应用

Application of operating room infection control based on PDCA cycle management mode in nursing of patients undergoing urologic endoscopic surgery

目的探讨基于PDCA循环管理模式下的手术室感染控制在泌尿外科腔镜手术患者护理中的应用效果。方法 2017年8月至2018年1月,我院泌尿外科手术室在职护理人员共26名,于2018年1月开始实施基于PDCA循环管理模式的手术室感染控制管理,实施前(2017年8—12月)及实施后(2018年1—4月)接受相关治疗护理的泌尿外科腔镜手术患者分别为485例和594例。比较实施前后手术室感染监测合格率、手术感染率、手术室安全隐患事件发生率;采用中文版护士行为目标达成度评价量表(NPGA),实施前后护理人员行为目标达成度评估情况。结果实施后,手术室感染监测合格率、护理人员NPGA自主决策、共情及共同参与、沟通、团队角色、团队协作、个性化护理措施评分均较实施前升高,手术感染率、手术室安全隐患事件发生率则均较实施前降低(P <0. 05);实施前后NPGA尊重患者评分比较差异无统计学意义(P>0. 05)。结论基于PDCA循环管理模式的手术室感染控制的实施,可显著提升手术室感染监测合格率,降低泌尿外科腔镜手术患者手术感染率和手术室安全隐患事件发生率,对改善护理人员行为目标达成度有一定帮助。

Objective To explore the application effect of operating room infection control based on PDCA cycle management mode in nursing of patients undergoing urologic endoscopic surgery.Methods To compare the qualified rate of infection monitoring in the operating room,the rate of surgical infection,and the incidence of potential safety accidents in the operating room;and to compare the assessments of the goals of behavior of nursing staff before and after implementation by means of nurse's performance for goal attainment(NPGA),26 in-service nursing staffs in the urology operating room of our hospital from August 2017 to January 2018.In January 2018,the implementation of operating room infection control management based on PDCA cycle management mode began.485 patients before implementation (August-December 2017) and 594 patients after implementation (January-April 2018) underwent urologic endoscopic surgery.Results After implementation the scores of qualified rate of infection monitoring in the operating room,nursing staff NPGA decision-making,empathy and joint participation,communication,team role,teamwork,personalized nursing measures were higher than before implementation.After implementation the rate of surgical infection,and the incidence of potential safety accidents were lower than before implementation(P <0.05).There was no statistical significance in the difference of the score in NPGA respecting patients before and after implementation(P >0.05).Conclusion The implementation of operating room infection control based on PDCA cycle management mode could significantly improve the qualified rate of operating room infection monitoring,reduce the incidence of surgical infection and surgical safety hazard in patients undergoing urologic endoscopic surgery,and helpful to improve the achievement of the goal of behavior of nursing staff.