首页|PDCA模式在外科重症监护病区医院感染防控中的应用及其效果

PDCA模式在外科重症监护病区医院感染防控中的应用及其效果

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目的 探讨PDCA管理模式在外科重症监护病区医院感染防控中的应用及其效果.方法 选取北京大学人民医院外科重症监护病区2016年1月—2022年12月医院感染和防控措施落实相关数据;2016年1-12月为PDCA模式应用前阶段,2017年1月—2022年12月为PDCA模式应用后阶段.比较应用PDCA模式前后医院感染发生和防控措施落实效果的变化.结果 应用PDCA模式前监测住院患者1 135例,应用PDCA模式期间监测住院患者6 566例;应用PDCA模式后,外科重症监护病区的医院感染率降低,由2016年的4.67％下降至2022年的1.89％,并且呈逐年下降趋势(P＜0.05);多药耐药菌医院感染率显著下降,由2016年的2.91％下降至2022年的0.56％,且逐年下降(P＜0.05),呼吸机相关性肺炎、中心静脉导管血流感染及导尿管相关泌尿系感染发生率均下降(P＜0.05),呼吸机相关性肺炎发生率由2016年的8.49‰下降至2022年的2.63‰,中心静脉导管血流感染发生率由2016年的8.08‰下降至2022年的1.70‰,导尿管相关泌尿系感染发生率由2016年的1.95‰下降至2022年的0.00‰;医务人员手卫生依从性有所提升(P＜0.05),由50.91％提升至70.18％,环境清洁消毒效果监测合格率自2018年后升高(P＜0.05),由76.42％提升至86.25％.结论 PDCA模式可有效提升外科重症监护病区的医院感染防控管理水平,降低外科重症监护病区医院感染率.
Evaluation of effect of PDCA model on prevention and control of healthcare-associated infection in surgical intensive care unit
OBJECTIVE To explore the effect of plan-do-check-action(PDCA)cycle on the prevention and control of healthcare-associated infection in surgical intensive care unit.METHODS Data related to hospital-associated in-fection and the implementation of prevention and control measures in the surgical intensive care unit of Peking U-niversity People's Hospital from Jan.2016 to Dec.2022 were selected.Jan.to Dec.2016 was the pre-application stage of the PDCA model,Jan.2017 to Dec.2022 was the post-application stage of the PDCA model.Changes in the occurrence of hospital-associated infection and the effectiveness of the implementation of prevention and control measures before and after the application of the PDCA model were compared.RESULTS Totally 1 135 hospitalized patients were monitored before the application of the PDCA model,6 566 hospitalized patients were monitored during the application of the PDCA model.After applying the PDCA model,the hospital-associated infection rate in the surgical intensive care unit decreased,from 4.67％ in 2016 to 1.89％ in 2022,exhibiting a downward trend year by year(P＜0.05).The rate of multi-drug resistant bacteria hospital-associated infection decreased signifi-cantly,from 2.91％ in 2016 to 0.56％ in 2022,and decreased year by year(P＜0.05).The incidence rate of venti-lator-associated pneumonia(VAP),central venous catheter bloodstream infection(CLABSI)and catheter-associ-ated urinary tract infection(CAUTI)all declined(P＜0.05),with the incidence rate of ventilator-associated pneu-monia decreasing from 8.49‰ in 2016 to 2.63‰ in 2022,the incidence rate of central venous catheter bloodstream infection decreasing from 8.08‰ in 2016 to 1.70‰ in 2022,and the incidence rate of urinary tract infections asso-ciated with catheters decreasing from 1.95‰ in 2016 to 0.00‰ in 2022.The hand hygiene compliance of medical staff increased(P＜0.05),from 50.91％ to 70.18％ ,and the environmental disinfection qualified rate increased(P＜0.05),from 76.42％ to 86.25％ .CONCLUSION The application of PDCA model effectively improved the management of hospital-associated infection prevention and control and reduced the occurrence of hospital-associat-ed infection in surgical intensive care unit.

PDCA modeIntensive care unitInfection controlEffect evaluationIncidence of hospital-associated infectionMultidrur-resistant organismDerice-associated infectionHand hygieneEnviromena cleaning and dis-infection

陈美恋、王守军、郝云霄、匡季秋

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北京大学人民医院感染管理-疾病预防控制处,北京 100044

PDCA模式 重症监护病区 医院感染防控 效果评价 医院感染率 多药耐药菌 器械相关感染 手卫生 环境清洁消毒

教育部重点实验室(北京大学)开放基金资助项目

2024204

2024

10.11816/cn.ni.2024-248157

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子：1.885
ISSN：1005-4529
年,卷(期)：2024.34(19)