PDCA管理结合敏感指标改进在预防心脏手术切口感染中的应用  

Application of PDCA Management Combined with Sensitive Indicators Improvement in the Prevention of Cardiacsurgical Site Infection

作　　者：鲁为凤[1] LU Wei-feng(Dept.of Theater,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital,Chengdu Sichuan 610072,China)

机构地区：[1]四川省医学科学院,四川省人民医院手术室,四川成都610072

出　　处：《昆明医科大学学报》2019年第1期142-146,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81300768)

摘　　要：目的研究PDCA管理结合敏感指标改进在预防心脏手术切口感染(SSI)中的应用效果,为提高手术室管理水平提供参考依据。方法将2017年3月至2017年12月四川省人民医院心脏手术患者280例随机均分为观察组(PDCA管理方案)和对照组(常规围术期管理)各140例进行干预,比较2组干预后各敏感指标控制效果及SSI发生率,并分析PDCA循环实施时间与SSI发生率的关系。结果观察组患者高血压及糖尿病控制率、无菌操作规范达标率、抗菌药物应用合理率、术前住院时间≤7 d比例、手术时间≤5 h比例高于对照组,抗菌药物使用率和抗菌药物联合应用率低于对照组,差异有统计学意义(P<0.05);观察组实施PDCA后6～9个月和总体SSI发生率低于对照组,差异有统计学意义(P <0.05);Pearson相关系数分析结果显示PDCA实施时间与心脏手术患者术后SSI发生率呈明显负相关性(r=-0.495,P <0.05)。结论 PDCA循环用于心脏手术患者围术期干预可持续改进SSI相关敏感指标,提高手术室管理水平为,降低患者术后切口感染发生率。Objective To study the application effects of PDCA management combined with sensitive indicators improvement in the prevention of cardiac surgical site infection(SSI),and to provide reference for improving the operating roommanagement level.Methods 280 cases of patients with cardiac surgeries in our hospital from March 2017 to December 2017 were randomly divided into the observation group(PDCA management regimen)and the control group(conventional perioperative management),with 140 cases in each group.The control effects of each sensitive indicator after intervention and the incidence rate of SSI were compared between the two groups.And the relationship between PDCA cycle implementation time andincidence rate of SSI was analyzed.Results The control rates of hypertension and diabetes,the pass rate of aseptic operation,the rational rate of antibiotic application,the ratio of preoperative hospital stay≤7 d and the ratio of operative time≤5 h in the observation group were higher than those in the control group,and the use rate of antibacterial drugs and the combined application rate of antibiotic drugs were lower than those in the control group(P<0.05).The overall SSI incidence rate at 6-9 months after PDCA in observation group was lower than that in control group.Pearson correlation coefficient analysis showed that PDCA implementation time was significantly negatively correlated with postoperative SSI incidence rate in patients undergoing cardiac surgery(r=-0.495,P<0.05).Conclusion s PDCA cycle for perioperative intervention in patients undergoing cardiac surgery can persistently improve SSI-related sensitive indicators,enhance the operating roommanagement level,and reduce the incidence rate of postoperative wound infection.

关 键 词：管理质量 PDCA 敏感指标 心脏手术 切口感染 

分 类 号：R654[医药卫生—外科学]