基于SWOT法的外科免冲洗手消毒PDCA方法及实践效果  

Effect of PDCA management based on SWOT method on waterless surgical hand antisepsis and its practice

作　　者：文玉琴 张云婷 丁玲玲 WEN Yu-qin;ZHANG Yun-ting;DING Ling-ling(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院麻醉科手术室,北京100010

出　　处：《中华医院感染学杂志》2024年第4期624-627,共4页Chinese Journal of Nosocomiology

基　　金：北京市“首都特色”科技计划基金资助项目(Z171100001017061)。

摘　　要：目的 探讨基于SWOT法的计划(P)、实施(D)、检查(C)、处理(A)(PDCA)管理对外科免冲洗手消毒效果的影响.方法 于2019年1月—2022年12月采取PDCA管理模式对医务人员外科免冲洗手消毒效果进行干预,分析干预前后人员理论知识知晓率、操作正确率、外科手消毒后手卫生监测合格率及医院感染率相关性.结果 PDCA循环持续改进后,干预后外科手消毒理论知识消毒目的知晓率、原则知晓率、范围知晓率、时间知晓率分别为98.00%、92.00%、100.00%、100.00%均高于干预前(P<0.05);操作正确率除指甲符合要求干预前后无显著差异外,干预后着装规范率、方法正确率、揉搓时间合格率分别为100.00%、98.00%、100.00%均高于干预前(P<0.05);干预后骨科院内感染率为0.42%低于干预前(P<0.05);干预后骨科腰椎、颈椎开放手术一类切口感染率0.50%低于干预前0.95%,无明显统计学差异(P=0.540);干预后医务人员外科免冲洗手消毒手部细菌学监测合格率100.00%高于干预前98.00%(P<0.05).结论 基于SWOT法的PDCA管理,可有效提高外科免冲洗手消毒的管理质量,提高医护人员外科手消毒的正确率及合格率,降低一类切口感染率,从而减少院内感染的发生.OBJECTIVE To investigate the impact of Plan(P),Do(D),Check(C)and Action(A)(PDCA)man-agement based on SWOT method on the effectiveness of waterless surgical hand antisepsis.METHODS From Jan.2019 to Dec.2022,the PDCA management mode was adopted to intervene on the effect of waterless surgical hand antisepsis for medical staff,and the correlation between the awareness rate of theoretical knowledge,the rate of correct operation,the qualified rate of hand hygiene monitoring after surgical hand antisepsis and the hospital in-fection rate before and after the intervention were analyzed.RESULTS After the continuous improvement of PDCA cycle,the awareness rates of purpose,principle,scope and time of surgical hand antisepsis theoretical knowledge after intervention were 98.00%,92.00%,100.00%and 100.00%,respectively,which were higher than before intervention(P<0.05).There was no significant difference in the fingernails met the requirements before and af-ter the intervention,the dress standard rate,method accuracy rate and kneading time qualified rate after interven-tion were 100.00%,98.00%and 100.00%respectively,which were higher than 80.00%,70.00%and 66.00%before intervention(P<0.05).The rate of nosocomial infection in orthopaedics after intervention was 0.42%,which was lower than 1.40%before intervention(P<0.05).After intervention,the rate of type one incisions in-fection for orthopedic lumbar and cervical open surgery was 0.50%,which was lower than 0.95%before inter-vention.After intervention,the rate of qualified bacteriological monitoring of waterless surgical hand antisepsis was 100.00%,which was higher than that of 98.00%before intervention.CONCLUSION PDCA management based on SWOT method effectively improved the management quality of waterless surgical hand antisepsis,im-proved the correct rate and qualified rate of surgical hand antisepsis of medical staff,reduced the infection rate of first-class incision,and thus reduced the incidence of nosocomial infection.

关 键 词：SWOT PDCA管理 免冲洗 外科手消毒 方法 实践效果 

分 类 号：R187[医药卫生—流行病学]