PDCA循环在医院环境卫生监管中的应用

Application of PDCA cycle in hospital environmental hygiene supervision

目的探讨PDCA循环在医院环境卫生监督管理工作中的应用效果。方法运用PDCA工具对医院环境卫生实施监督管理,比较实施监管模式前后物体表面耐甲氧西林金黄色葡萄球菌(MRSA)、多重耐药(MDR)不动杆菌检出率,以及ATP荧光检测合格率。结果实施PDCA循环监管模式后,两个科室环境物体表面MDR不动杆菌检出率(0.96%),MRSA和MDR不动杆菌总检出率(6.73%)较干预前(分别为8.04%、15.18%)均降低,差异均有统计学意义(均P<0.05)。干预前共检出多重耐药菌17株,其中床旁仪器7株,地面、配奶用具、病床各检出2株;干预后共检出多重耐药菌7株,其中床旁仪器、地面各检出多重耐药菌2株。干预后环境表面ATP检测合格率为82.61%(38/46),高于干预前的58.33%(28/48),差异具有统计学意义(χ^2=8.451,P=0.004)。结论应用PDCA循环监管模式,主动发现问题,严格控制过程管理,能有效降低医院环境物体表面MRSA和MDR不动杆菌检出率,保障医疗环境清洁卫生,维护医疗安全。

Objective To explore the application efficacy of plan-do-check-act(PDCA)cycle in hospital environmental hygiene supervision and management.Methods PDCA tools were adopted to supervise and manage hospital environmental hygiene,isolation rates of methicillin-resistant Staphylococcus aureus(MRSA)and multidrug-resistant(MDR)Acinetobacter,as well as qualified rate of ATP fluorescence detection before and after the implementation of supervision mode were compared.Results After the implementation of PDCA cycle supervision mode,isolation rate of MDR Acinetobacter,overall isolation rate of MRSA and MDR Acinetobacter on the surface of environmental objects in two departments were both lower than those before intervention(0.96%vs 8.04%;6.73%vs15.18%,respectively),with statistical significance(both P<0.05).Before intervention,a total of 17 strains of MDROs were isolated,7 strains of MDROs were isolated from bedside instruments,and 2 strains were isolated from ground,dairy appliances and ward bed respectively;after intervention,a total of 7 strains of MDROs were isolated,2 strains were isolated from bedside instruments and ground respectively.Qualified rate of ATP detection on environmental surface after intervention was higher than before intervention(82.61%[38/46]vs 58.33%[28/48],χ^2=8.451,P=0.004).Conclusion Applying PDCA cycle supervision mode,active finding out problems and strictly controlling process management can effectively reduce the isolation rates of MRSA and MDR Acinetobacter on the surface of hospital environmental objects,ensure medical environmental hygiene and maintain medical safety.