持续质量改进(CQI)痰液管理在结核感染控制中的成效分析  

Analysis of the effectiveness of continuous quality improvement(CQI)sputum management in tuberculosis infection control

作　　者：潘稚芬[1] 袁亚芳 陆锦琪[1] 钱建萍 PAN Zhifen;YUAN Yafang;LU Jinqi;QIAN Jianping(The First Affiliated Hospital of Jiaxing University(First Hospital of Jiaxing),Jiaxing 314000,China;Department of Cadres and Geriatrics,Fuyang People's Hospital in Anhui Province,Fuyang 236000,China)

机构地区：[1]嘉兴学院附属第一医院(嘉兴市第一医院),浙江嘉兴314000 [2]安徽省阜阳市人民医院干部老年科,安徽阜阳236000

出　　处：《中国现代医生》2019年第1期87-91,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2016KYB288)

摘　　要：目的探讨肺结核患者痰液管理中的持续质量改进措施,为医院结核感染与预防控制策略提供思路。方法对2010年1月～2012年12月2501例肺结核患者(其中53例机械通气患者)在医院诊治过程中存在的院内感染风险因素进行分析并进行持续质量改进(CQI),于2013年1月～2017年12月制定相应的改进措施及防护策略,分析持续质量改进(CQI)前后医护人员院内结核感染发生率及对结核感染控制措施的满意度,继而评价持续质量改进(CQI)在结核感染控制中的成效。结果 CQI改进前3年间收治2501例肺结核患者,发现10例医护人员感染肺结核;CQI改进后5年间收治8478例肺结核患者,结核病区医护人员无1例发生院内结核感染,差异有统计学意义(χ~2=29.55,P<0.01);改进前满意度为(91.92±1.69)分、改进后为(97.07±1.92)分,结核感控满意度有所提升(t=10.12,P<0.01)。结论将目视教育、新型痰杯研制、机械通气中细节管理等持续质量改进(CQI)措施应用在结核感染控制的具体实践中,可提高医院结核感染控制水平。Objective To explore the continuous quality improvement measures in sputum management of tuberculosis patients,and to provide ideas for hospital tuberculosis infection,prevention and control strategies.Methods The risk factors for nosocomial infection during hospital diagnosis of 2501 patients with pulmonary tuberculosis(53 of them were mechanically ventilated)from January 2010 to December 2012 were analyzed.And continuous quality improvement(CQI)was performed.Corresponding improvement measures and protection strategies from January 2013 to December 2017 were developed.The incidence of tuberculosis infection of medical staff in hospitals and the satisfaction of tuberculosis infection control measures before and after continuous quality improvement(CQI)were analyzed.And then the effectiveness of continuous quality improvement(CQI)in tuberculosis infection control was evaluated.Results During 3 years before CQI improvement,2501 patients with pulmonary tuberculosis were admitted,and 10 medical staff were found to be infected with tuberculosis.Within the 5 years after CQI improvement,8478 patients with pulmonary tuberculosis were admitted.No tuberculosis infection occurred in medical staff in tuberculosis area.The difference was statistically significant(χ^2=29.55,P<0.01).Satisfaction before improvement was(91.92±1.69)scores,and satisfaction after improvement was(97.07±1.92)scores,and satisfaction with tuberculosis was improved(t=10.12,P<0.01).Conclusion Continuous quality improvement(CQI)measures such as visual education,new cup preparation,and detailed management of mechanical ventilation can be applied to the specific practice of tuberculosis infection control,which can improve the control level of tuberculosis infection in hospitals.

关 键 词：持续质量改进 肺结核 痰液管理 感染预防与控制 

分 类 号：R52[医药卫生—内科学]