PDCA循环管理方法在多重耐药菌预防控制中的应用

摘要

Objective To evaluate the effect of plan-do-check-act (PDCA) cycle management method on improving multidrug-resistant organisms (MDROs) prevention and control measures.Methods PDCA cycle management method was applied to improve the management system and management process of a hospital,prevention and control efficacy of MDROs in clinic departments between July-December 2014 (before PDCA implementation) and January-June 2015 (after PDCA implementation) was compared.Results After half a year implementation of PDCA cycle management,the total implementation rate of MDROs prevention and control measures increased from 57.14％ (360/630) to 79.69％ (510/640),difference was statistically significant(P＜0.05);implementation rate of recording by doctors during the disease course,recording by nurses during the nursing process,registration and reporting of MDROs,as well as posting isolation signs were all improved,difference was statistically significant (all P＜0.05).The total isolation rate of MDROs declined from 30.65％ (347/1 132)before PDCA implementation to 22.61％ (236/1 044) after PDCA implementation,difference was statistically significant (x2 =10.393,P＜0.05).Conclusion Application of PDCA cycle can improve the prevention and control measures of MDROs.%目的 评价计划-实施-检查-处理(PDCA)循环管理方法提高多重耐药菌(MDROs)预防控制措施的效果.方法 应用PDCA循环管理方法完善某院管理制度,改善管理流程等,比较2014年7-12月(PDCA执行前)和2015年1-6月(PDCA执行后)临床科室MDROs预防控制效果.结果 执行PDCA循环管理方法半年后,MDROs防控措施总执行率从57.14％ (360/630)提高至79.69％ (510/640),差异有统计学意义(P＜0.05);医生在病程中记录、护士在护理病程中记录、登记上报和张贴隔离标识的执行率均有所提高,差异均有统计学意义(均P＜0.05).MDROs总检出率从PDCA执行前的30.65％(347/1 132),降至PDCA执行后的22.61％ (236/1 044),差异具有统计学意义(x2=10.393,P＜0.05).结论 PDCA循环管理方法能改善MDROs预防控制效果.