循证医学应用于门诊医院感染预防流程的管理  

Process management of hospital infection control in outpatient department under evidence-based medicine

作　　者：姒怡冰[1] 朱会耕[2] 叶婷[1] 冯蔚如[2] 秦越翠[2] 李光辉[3] 

机构地区：[1]复旦大学附属华山医院护理部,上海200040 [2]复旦大学附属华山医院门诊部,上海200040 [3]复旦大学附属华山医院医院感染管理科,上海200040

出　　处：《中华医院感染学杂志》2012年第11期2366-2368,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨循征医学应用于门诊医院感染控制流程建立及实施效果评价。方法通过采用循证医学的方法,对门诊医院感染管理流程、医务人员培训流程、预检流程、操作流程、重点部门监测流程、医疗废弃物处理流程进行系统评价、整合证据、优化流程、应用实施,建立了一套完整、系统、质量持续改进的门诊医院感染控制管理流程。结果流程管理实施前医院感染预防知识知晓率、手卫生依从性、标准预防执行率分别为78.9%、51.1%、77.8%,实施后为88.6%、87.2%、91.5%,差异有统计学意义(P<0.05);流程管理实施后明显改善了消毒隔离质量管理及废弃物处理管理。结论循证医学向医院管理者提供了科学的方法,基于此基础的流程管理,使门诊医院感染预防与控制更具科学性与实用性,并实现医院感染管理规范化、常态化。OBJECTIVE To explore the application of evidence-based medicine on establishment of the process of hospital infection control in outpatient department and to evaluate the effect.METHODS The methods of evidence-based medicine were used systematically evaluate all the process of outpatient department about the hospital infection control,personal training,precheck,operation process,monitoring of the key department,medical wastes disposal,evidence integration,process optimization and implementation.We established a suite of completed,systemic and continuous quality improvement for the process management of hospital infection control.RESULTS The awareness rate of knowledge of nosocomial infection prevention,the hand hygiene compliance rate,and the implementation rate of standard prevention were 78.9%,51.1%,and 77.8% before the implementation of process management,respectively,and 88.6%,87.2%,and 91.5% after the implementation,the differences were statistically significant（P〈0.05）;the management of disinfection and the disposal of medical waste were improved significantly after implementation of process management.CONCLUSION Evidenced-based medicine provides scientific method for the hospital administers,the process management based on the evidenced-based medicine can make the control and prevention of infections in outpatient department more scientific and practical so as to achieve the standardized and normalized management of nosocomial infections.

关 键 词：门诊 循证医学 医院感染控制 流程管理 

分 类 号：R197.323[医药卫生—卫生事业管理]