基于FOCUS-PDCA模式中西医结合降低老年消化道肿瘤患者术后医院感染发生率  

The integration of traditional Chinese and western medicine based on FOCUS-PDCA mode reduced the postoperative nosocomial infection rate of elderly patients with gastrointestinal tumor

作　　者：刘丝雨 李淑敏 李东芳 王云启 陈凡 晏娟 郭敏 邓皓文 李阳 周艳华 LIU Siyu;LI Shumin;LI Dongfang;WANG Yunqi;CHEN Fan;YAN Juan;GUO Min;DENG Haowen;LI Yang;ZHOU Yanhua(Graduate School,Hunan University of Chinese Medicine,Changsha,410208,Hunan,China;Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha,410013,Hunan,China)

机构地区：[1]湖南中医药大学研究生院,湖南长沙410208 [2]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院,湖南长沙410013

出　　处：《肿瘤药学》2023年第3期374-380,共7页Anti-Tumor Pharmacy

基　　金：湖南省中医药管理局重点项目(A2023053);湖南省中医药科研计划项目(2020103);湖南省自然科学科委联合基金(2020JJ8088);2020年中央财政补助中医药事业传承与发展经费(湘财社指导[2019]0099)。

摘　　要：目的探讨中西医结合应用持续质量改进(FOCUS-PDCA)模式对老年消化道肿瘤患者术后医院感染率的影响。方法随机选取2018年1月—2018年6月我院收治的100例患者设为对照组,2019年1月—2019年6月收治的100例患者设为研究组。研究组通过医护、院感、药学多学科诊疗团队(MDT)进行FOCUS-PDCA模式管理,包括制度改进、医护培训、患者中西医结合治疗等干预措施;对照组按原管理模式进行干预。通过对比两组患者的住院时间、不同标本(呼吸道、消化道、泌尿系统、伤口分泌物)阳性率、主要病原菌分离度等来评价两组疗效差异。结果研究组患者住院时间短于对照组(P<0.05);两组患者呼吸道、消化道以及伤口分泌物标本阳性率比较,差异有统计学意义(P<0.05);在主要病原菌分离度比较中,研究组大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌的分离度均明显低于对照组(P<0.05),两组患者肺炎链球菌和白色假丝酵母菌的分离度无显著差异(P>0.05)。结论中西医结合应用FOCUS-PDCA模式可降低老年消化道肿瘤患者的术后感染率,降低院感风险。Objective To explore the effect of FOCUS-PDCA(find,organize,clarify,understand,select,plan,do,check and act)mode on the postoperative nosocomial infection rate of elderly patients with digestive tract tumors.Methods A total of 100 patients admitted in our hospital between January 2018 and June 2018 were randomly selected as the control group,and 100 patients admitted between January 2019 and June 2019 were selected as the study group.The study group was managed by the FOCUS-PDCA mode through the multi-disciplinary team(MDT)of medical care,nosocomial infection control and pharmacy.The intervention measures included system improvement,medical and nursing training,and integrated traditional Chinese and western medicine treatment for patients.The control group received the original management mode.The curative effect of the two groups was evaluated by comparing the duration of hospital stay,the positive detection rate of different specimens(respiratory tract,digestive tract,urinary tract,wound secretion),and the separation degree of main pathogenic bacteria.Results The duration of hospital stay in the study group was shorter than that in the control group(P<0.05).There were statistically significant differences in the positive rates of specimens from respiratory tract,digestive tract and wound secretion between the two groups(P<0.05).The isolation rates of Escherichia coli,Klebsiella pneumoniae,and Staphylococcus aureus in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the isolation rate of Streptococcus pneumoniae and Candida albicans between the two groups(P>0.05).Conclusion The combined application of FOCUS-PDCA mode and integration of traditional and western medicine has reduced the postoperative infection rate of elderly patients with gastrointestinal tumors and reduced the risk of nosocomial infection.

关 键 词：FOCUS-PDCA模式 老年消化道肿瘤 医院感染 术后感染 

分 类 号：R735[医药卫生—肿瘤]