应用六西格玛管理方法控制多药耐药菌医院感染  

Application of six-Sigma management in control of nosocomial infections caused by multidrug-resistant bacteria

作　　者：徐润琳[1] 罗万军[1] 王文娟[1] 许渝[1] 鲍连生[1] 徐巍[1] 

机构地区：[1]武汉市儿童医院院感科,湖北武汉430016

出　　处：《中华医院感染学杂志》2014年第2期495-497,共3页Chinese Journal of Nosocomiology

基　　金：武汉市卫生科研基金项目(WG12C09)

摘　　要：目的探讨利用六西格玛管理控制多药耐药菌医院感染的效果。方法应用六西格玛管理的DMAIC流程,即定义阶段、测量阶段、分析阶段、改进阶段和控制阶段,找出引起医院感染的主要原因,针对原因采取控制和改进措施。结果改进前发生多药耐药菌医院感染率为5.39%,Z值1.908,对影响因子进行回归分析,得出患儿病情、住院天数、侵入性操作、洗手次数、接受培训次数等均是影响感染率的显著因子;严格落实各项措施后,得出改进后多药耐药菌医院感染率为3.31%,Z值由1.908提高至2.547;对改进前后感染率进行χ2分析,得出χ2=6.667,P≤0.01,说明改进措施落实有效。结论通过六西格玛管理能有效缩短患儿住院天数,提高病床周转率,带来了巨大的经济效益,同时提高了患儿满意度,产生了较好的社会效益;在引进六西格玛管理的过程中,必须结合本单位自身的特点,不断摸索、探寻最适合的个性化六西格玛管理模式,使之为医院质量管理奉献出巨大能量。OBJECTIVE To explore the effect of six-Sigma management on control of nosocomial infections caused by multidrug-resistant bacteria. METHODS The DMAIC workflow of six-Sigma management, which was defined as the defining-easuring-analyzing-improving-controlling, was used to identify the main causes of nosocomial infec- tions, then the control and improvement measures were put forward in response to the causes. RESULTS The inci- dence of nosocomial infections caused by the multidrug-resistant bacteria was 5.39 % before the improvement, with the Z value of 1. 908. The regression analysis of the influencing factors concluded that the condition of illness, hos- pitalization duration, invasive operation, frequency of hand washing, and frequency of training were the high-risk factors that influenced the infection rate. After the implementation of the improvement measures, the incidence of the nosocomial infections was 3.31%, and the Z value increased from 1. 908 to 2. 547; the result of chi-square test for the infection rate demonstrated χ2 = 6. 667, （P≤0.01）, indicating that the improvement measures were effec- tive. CONCLUSION The application of six-Sigma management can shorten the hospitalization duration, increase the bed turnover rate, bring huge economic benefits, improve patients satisfaction, and contribute to the social bene- fits. As the six-Sigma management is introduced, it is necessary to explore and seek the most suitable and person- alized six-Sigma management mode by combining with their own characteristics so as to contribute to the hospital management quality.

关 键 词：六西格玛管理 多药耐药菌 医院感染 

分 类 号：R197.323[医药卫生—卫生事业管理]