PDCA在医院感染实时监控系统感染疑似病例预警信息处置管理中的应用

Application of PDCA cycle in improving the timely processing rate of warning information on Real-time Nosocomial Infection Surveillance and Control System

目的通过戴明循环(Plan-Do-Check-Act cycle,PDCA循环)促进临床医生对医院感染实时监控系统感染疑似病例预警信息处置的积极主动性,提高预警信息及时处置率。方法在2018年3月-12月期间,按照PDCA管理工具,对感染疑似病例预警信息及时处置率较低的原因进行分析、执行改进策略和措施、严格检查督导,比较实施PDCA循环管理前后临床医生对RTNISS中感染疑似病例预警信息处置的相关情况以及医院感染病例漏报率的变化。结果从2018年3月-12月,临床医务人员对本科室预警信息及时处置情况的知晓率显著提高(χ^2=14.389,P<0.001)。2018年12月全院预警信息24 h及时处置率为66.64%,72 h及时处置率为80.01%,均较2018年3月提高(P<0.001);感染预警病例24 h及时处置率≥60%的科室占67.35%,72 h及时处置率≥80%的科室占65.31%,均较2018年3月提高(P<0.001);全院医院感染病例漏报次数率为14.74%,较2018年3月显著降低(χ^2=53.870,P<0.001)。结论通过采用PDCA循环管理,能有效促进临床医生对RTNISS中感染疑似病例预警信息处置的积极主动性,提高全院预警信息及时处置率,降低医院感染病例漏报次数率。

OBJECTIVE To promote the clinicians to process the warning information timely on Real-time Nosocomial Infection Surveillance and Control System(RTNISS)by applying Plan-Do-Check-Act(PDCA)cycle.METHODS Based on rationally analyzing the causes for of the low processing rate of warning information,and effectively conducting strategies to keep continuous quality improvement according to PDCA cycle during March to December 2018,the processing rate of warning information and the under-reporting rate of nosocomial infection cases before and after PDCA cycle were statistically compared.RESULTS From March to December 2018,the popularizing rate on timely processing the warning information among the clinicians was significantly increased(χ^2=14.389,P<0.001).The 24-hour processing rate in December 2018 was 66.64%,and the 72-hour processing rate was 80.01%,both of which were significantly higher than those that in March 2018 with significant differences(P<0.001).In December 2018,the proportion of clinical departments with 24-hour processing rate≥60%was 67.35%,and that with 72-hour processing rate of≥80%was 65.31%,both of which were significantly higher than those that in March 2018(P<0.001).The under-reporting rate of nosocomial infection cases was 14.74%in December 2018,which was significantly lower than that in March 2018(χ^2=53.870,P<0.001).CONCLUSION By adopting PDCA cycle management,it can effectively promote the proactiveness of clinicians in processing the warning information of suspected nosocomial infection cases in RTNISS,improve the timely processing rate of warning information,and reduce the under-reporting rate of nosocomial infection cases.