精益管理在精神科改良电痉挛治疗感染预防与控制管理中的应用

Practice of Lean Management in Infection Prevention and Control of MECT in Psychiatry

目的运用精益管理理念,建立精神科改良电痉挛治疗(MECT)感染预防与控制管理策略并进行实践效果评价。方法采用精益管理对MECT感染预防与控制管理现状进行分析,从建立有效的感染预防与控制管理组织、优化MECT室功能区域设置、完善治疗流程和应急处置预案、合理调配人力资源、强化各级各类人员培训、利用数据化指标促进质量改善等6个层面,提出精神科MECT感染预防与控制管理策略,每月进行质量指标的监测。结果精益管理实施后,环境与物体表面清洁消毒合格率、重复使用的擦拭布巾清洗消毒合格率、使用后呼吸机及附件清洗消毒合格率、手卫生依从率、手卫生正确率、培训合格率较实施前均提高(P<0.05);统计初期与统计末期MECT三级核查率、重复使用护目镜或防护面屏清洗消毒合格率差异无统计学意义(P>0.05);统计初期,消毒液配制正确率、空气消毒正确率即达到100%,且在统计周期内较好地保持。结论基于精益管理策略的MECT单元感染预防与控制管理有效保障了医疗安全,可供精神卫生专科医院参考。

Objective The concept of lean management was used to established the infection prevention and control management strategy of modified electroconvulsive therapy(MECT)in psychiatric department and evaluated the practical effect.Methods Lean management was used to analyze the current situation of infection and control management of MECT.From six aspects,such as establishing effective infection prevention and control management organization,optimizing the functional area setting of MECT room,perfecting the treatment process and emergency response plan,rationally allocating human resources,strengthening the training of all kinds of personnel at all levels and promoting the quality improvement by using digital indicators,the management strategy of infection prevention and control of MECT in psychiatric department was put forward,and the quality indicators were monitored every month.Results After the implementation of lean management,the qualified rate of cleaning and disinfection of environment and object surfaces,cleaning and disinfection of reusable wipes,cleaning and disinfection of ventilators and accessories after use,implementation rate,correct hand hygiene rateof hand hygiene and training rate all increased(P<0.05).There was no statistical difference in MECT three-level verification rate and qualified rate of repeated use of goggles or protective screen cleaning and disinfection between the initial and final stages of statistics(P>0.05).At the initial stage of statistics,the correct rate of disinfectant preparation and air disinfection reached 100%,and they were well maintained in the statistical period.Conclusion MECT unit infection prevention and control management based on lean management strategy effectively guarantees medical safety,which can be used as a reference for mental health hospitals.