PDCA循环用于提高重症医学科医务人员手卫生依从性效果分析

Analysis of the effect of PDCA cycle on improving hand hygiene compliance of medical staff in intensive care unit

目的研究PDCA循环对重症医学科(ICU)医务人员手卫生依从性的影响。方法将PDCA循环管理方法应用到手卫生中,研究干预前后ICU医务人员手卫生依从率、正确率及手卫生相关监测指标变化情况。结果PD⁃CA循环管理实施后,手消毒剂及洗手液每床日用量较前明显提高,手卫生依从率从64.8%提高到87.4%,正确率从68.9%提高到91.0%,差异均有统计学意义(P<0.001)。在不同的职业中,医师、护士及护理员手卫生依从率在PDCA实施后均明显上升(P<0.05),医师、护士手卫生正确率在PDCA实施后均明显上升(P<0.05)。手卫生“五时刻”的手卫生依从率均有提高(P<0.05),其中“接触患者后”及“接触患者周围环境后”的手卫生依从率较前提高最为显著。结论将PDCA循环管理方法应用于手卫生管理中,可有效提高ICU医务人员手卫生依从率和正确率,应不断提高ICU医务人员手卫生依从性情况,并始终贯彻执行。

Objective To study the effect of PDCA cycle on hand hygiene compliance of medical staff in intensive care unit(ICU).Methods The PDCA cycle management method was applied to hand hygiene,and the compliance rate and correct rate of ICU medical staff's hand hygiene before and after the intervention were studied,as well as the changes in hand hygiene-related monitoring indicators.Results After the implementation of PDCA cycle management,the daily consumption per bed of hand disinfectants and hand sanitizers increased significantly,the hand hygiene compliance rate increased from 64.8%to 87.4%,and the correct rate increased from 68.9%to 91.0%,and the differences were statistically significant(P<0.001).In different occupations,the hand hygiene compliance rates of doctors,nurses and caregivers were significantly increased after PDCA implementation(P<0.05),and the hand hygiene correct rates of doctors and nurses were increased significantly after PDCA implementation(P<0.05).The compliance rates of hand hygiene in the 5 indications of hand hygiene were all increased(P<0.05),and the hand hygiene compliance rates of“after touching patient”and“after touching patient’surrounding enviroment”increased most significantly.Conclusion The application of PDCA cycle management method in hand hygiene management can effectively improve the compliance rate and correct rate of ICU medical staff's hand hygiene,and continuously improve the implementation of hand hygiene in ICU medical staff,which should be implemented all the time.