PDCA循环在医院多重耐药菌管理中的应用

目的分析采用PDCA循环方法管理多重耐药菌(MDRO)前后MDRO检出率的变化。方法收集分析某三级甲等中医院PDCA循环实施前(2013年1月—2014年12月)和实施后(2015年1月—2016年12月)送细菌培养标本和MDRO检出情况。结果 PDCA循环实施前共送检标本14 889份,分离菌株6 345株,MDRO650株,MDRO检出率10.24%;PDCA循环实施后共送检标本17 856份,分离菌株7 568株,MDRO476株,MDRO检出率6.29%;PDCA实施前后MDRO检出率比较,差异有统计学意义(χ2=72.567,P0.001)。经Cochran-Armitage趋势检验,2013—2016年MDRO检出率随时间呈现出递减趋势(Z=-7.8856)。手卫生用品领取量和费用均有所增加。结论引进PDCA循环用于MDRO管理,医院的MDRO检出率降低。PDCA循环管理法可有效促进医院MDRO管理质量持续改进。

Application of PDCA cycle in the hospital management of multidrug resis tant organisms

ObjectiveTo analyze the change in isolation rates of multidrug resistant organisms (MDROs) before and after adopting plan do check act (PDCA) cycle method for management of MDROs. MethodsBacterial culture specimen submission and isolation of MDROs in a tertiary first class hospital before the implementation of PDCA cycle (January 2013 December 2014) and after implementation of PDCA cycle (January 2015 December 2016) were collected and analyzed. ResultsA total of 14 889 specimens were sent for detection before the implementation of PDCA cycle, 6 345 strains were isolated, 650 of which were MDROs, isolation rate of MDROs was 10.24%; after the implementation of PDCA cycle, 17 856 specimens were sent for detection, 7 568 strains were isolated, 476 were MDROs, isolation rate of MDROs was 6.29%; difference in MDRO detection rate before and after the implementation of PDCA was statistically significant （χ2=72.567，P＜0.001）. After Cochran Armitage trend test, the isolation rates of MDROs in 2013 2016 showed a decreased trend (Z=-7.8856). The amount and cost of hand hygiene products have increased. ConclusionBy carrying out PDCA cycle for MDROs management, the isolation rate of MDROs in hospital is reduced. PDCA cycle management method can effectively promote the continuous quality improvement of hospital MDROs management.