PDCA模式在多重耐药菌医院感染管理中的应用效果研究

Study on the effectiveness of PDCA model in the management of multi-drug resistant bacteria hospital infection

目的探讨PDCA模式在多重耐药菌医院感染管理中的应用效果。方法于2021年4月起开始采用PDCA循环管理模式防控院内多重耐药菌感染,比较观察PDCA模式应用前(2020年4月~2021年3月)与应用后(2021年4月~2022年3月)两个时段抗菌药物使用强度、多重耐药菌感染防控执行情况与多重耐药菌检出情况,评价管理效果。结果PDCA模式应用后多重耐药菌阳性检出率(0.45%)明显低于PDCA模式应用前(0.60%),差异有统计学意义(P<0.05)。PDCA模式应用后,多重耐药菌阳性患者开具隔离医嘱执行率97.60%、实施隔离措施执行率98.80%、粘贴隔离标识执行率98.20%、严格手卫生执行率97.01%、诊疗物品专用执行率95.81%、规范填卡上报执行率97.90%、增加清洁消毒频次执行率97.30%、物流保洁知晓率93.41%,均高于PDCA模式应用前,差异有统计学意义(P<0.05)。结论PDCA模式的应用可以有效规范多重耐药菌医院感染的防控管理,强化多重耐药菌医院感染防控质量,更好防控多重耐药菌院内传播与交叉感染。

Objective To investigate the effect of PDCA model in the management of multi-drug resistant bacteria hospital infection.Methods In April 2021,our hospital started to adopt the PDCA cycle management model to prevent and control multi-drug resistant bacterial infections in the hospital.Before and after PDCA mode application,we observed the antimicrobial drug use intensity,multiple drug-resistant bacteria infection control implementation and multi-resistant bacteria detection,evaluation management effect.Results After the application of PDCA model,the detection rate of multi-drug resistant bacteria positive in our hospital(0.45%)was significantly lower than that before the application of PDCA model(0.60%),and the difference was statistically significant(P<0.05).After the application of the PDCA model,the execution rate of the multidrug-resistant bacteria-positive patients issued isolation orders was 97.60%,the implementation rate of isolation measures was 98.80%,the implementation rate of pasting isolation signs was 98.20%,the implementation rate of strict hand hygiene was 97.01%,and the implementation rate of special diagnosis and treatment items was 95.81%.The implementation rate of standardized card filling and reporting was 97.90%,the implementation rate of increasing the frequency of cleaning and disinfection was 97.30%,and the awareness rate of logistics cleaning was 93.41%,all of which were higher than before the application of PDCA mode,and the difference was statistically significant(P<0.05).Conclusion The application of PDCA model can effectively standardize the prevention and control management of multidrug resistant bacteria hospital infection,strengthen the quality of multi-drug resistant bacteria hospital infection prevention and control,and better prevent and control the nosocomial transmission and cross-infection of multi-drug resistant bacteria.