根本原因分析法在消毒隔离质量持续改进中的应用

目的探讨根本原因分析法（rootcauseanalysis，RCA）在消毒隔离质量持续改进中的应用成效。方法成立RCA小组，通过RCA找出医务人员手卫生、紫外线灯监测及消毒液使用存在问题，制订针对性对策。比较RCA实施前后紫外线灯应用、手卫生和消毒液使用不合格情况及空气、手卫生和消毒液生物学监测结果。结果实施RCA前后紫外线灯应用、手卫生不合格情况比较，均P〈0．05，差异具有统计学意义；实施RCA后明显优于实施前，但实施RCA前后消毒液使用不合格情况比较，均P〉0．05，差异无统计学意义；实施RCA前后空气消毒、手卫生生物学监测不合格情况比较，均P〈0．05，差异具有统计学意义，实施RCA后明显优于实施前，但实施RCA前后消毒液生物学监测不合格情况比较，P〉0．05，差异无统计学意义。结论应用RCA在医院进行消毒隔离质量持续改进，能有效提高消毒隔离工作质量。

Application of RCA in continuous improvement of disinfection and isolation quality

Objective To investigate the effect of using root cause analysis （RCA） on the improvement of disinfectin and isolation. Methods A RCA group was established to find out the problems in disinfection and isolation. Then the related personnel were organized to study relevant knowledge, quality control was performed and disinfection management system was strictly executed. The managements of ultraviolet lamp, hand hygiene, use of disinfectants as well as the biological tests on air and hand were all compared between pre- and post-implementation of RCA. Results After implementing RCA, the use of ultraviolet lamp disinfection and hand hygiene were both improved than before implication （P 〈 0.05）. But use of disinfectant for disinfection before the RCA implementation was not significantly better than that after the implementation （P 〉 0.05）. Conclusion The implementation of RCA may notably improve the quality of disinfection and isolation.