持续质量改进在预防普外科患者术后感染效果分析  

Effect of continuous quality improvement on prevention of postoperative infections in patients of general surgery department

作　　者：刘欣菊[1] 谷海英[2] 刘欣梅 

机构地区：[1]山东省泰山医学院附属莱芜市人民医院妇外科,山东莱芜271100 [2]新汶矿业集团莱芜中心医院血透室,山东莱芜271103 [3]莱芜市妇幼保健院手术室,山东莱芜271100

出　　处：《中华医院感染学杂志》2013年第24期6004-6006,共3页Chinese Journal of Nosocomiology

基　　金：莱芜市医院科研基金资助项目(YYLX2012011)

摘　　要：目的探讨持续质量改进在预防普外科患者术后感染效果,降低普外科术后感染发生率。方法调查2010年1月-2012年12月普外科手术患者临床资料,2010年1月-2011年1月手术患者300例为对照组,2011年2月-2012年12月手术患者700例为试验组;对两组患者的感染率、导管使用率以及抗菌药物使用合理性进行比较,采用SPSS14.0进行统计分析,对计数资料采用χ2检验,对计量资料采用t检验。结果实施持续质量改进后发生相关术后导管相关性血流感染、气管插管相关感染、导尿管相关感染以及引流管相关感染发生率分别为7.21%、16.67%、7.26%、6.29%,明显低于持续质量改进前的21.40%、38.06%、25.59%、15.69%;持续质量改进后气管插管、中心静脉置管、泌尿道插管的使用率分别为28.08%、63.20%、87.54%,低于持续质量改进前的48.59%、67.87%、97.72%;持续质量改进后抗菌药物的使用率为54.86%,低于持续质量改进前的96.33%;实施持续质量改进后抗菌药物的使用费用以及天数明显降低,而合理率差异有统计学意义(P<0.05)。结论实施术后感染持续质量改进管理,各小组需要主动寻找感染源,并给以解决,同时强化管理意识和人员参与及时,继而有效控制术后感染的薄弱环节,降低术后感染率。OBJECTIVE To investigate the effect of continuous quality improvement on the control of postoperative infections in the patients of general surgery department so as to reduce the incidence of postoperative infections. METHODS The clinical data of the patients who were treated in the general surgery department from Jan 2010 to Dec 2012 were investigated, totally 300 eases of patients who underwent surgery from Jan 2010 to Jan 2011 were assigned as the control group, while 700 cases of patients who underwent surgery from Feb 2011 to Dec 2012 were set as the study group, then the incidence of infections, utilization rate of catheter, and rationality of use of antibiotics were observed and compared between the two groups, the statistical analysis was performed with the use of SPSS14.0 software, the chi-square test was conducted for the analysis of count data, and the t-test was carried out for the measurement data. RESULTS After the continuous quality improvement was implement, the incidence rates of the postoperative catheter-related bloodstream infections, intracheal catheter-related infections, urinary catheter-related infections, and drainage catheter-related infections were respectively 7. 21%, 16.67%, 7.26%, and 6. 29%, significantly lower than 21.40%, 38.06%, 25.59%, and 15.69% before the implementation of continu ous improvement; the utilization rates of the intracheal catheter, central venous catheter, and urinary catheter were respectively 28.08%, 63.20%, and 87.54% after the implementation of continuous quality improvement, lower than 48.59%, 67.87%, and 97.72% before the implementation of continuous quality improvement; the utilization rate of antibiotics was 54.86% after the implementation of continuous quality improvement, lower than 96.33% before the implementation of continuous quality improvement; both the medical cost of antibiotics and the medication duration have been significantly reduced since the continuous quality improvement was implemented, however, the difference in the rate of reasonable u

关 键 词：持续质量改进 普外科 术后感染 

分 类 号：R619.3[医药卫生—外科学]