目的 探讨消毒供应中心的管理方法，切实提高其质量。 方法 2008年8月－2010年12月应用PDCA循环管理模式，对消毒供应中心实施标准化、规范化、系统化和科学化的管理。 结果 应用PDCA循环管理模式以来，消毒供应中心的建筑布局及工作流程得以规范；手术器械处置效率、清洗消毒灭菌质量得以提高；手术切口、Ⅰ类手术切口的感染率均得以降低。2009年与2008年、2010年与2008年比较，手术切口感染率均得以降低，差异有统计学意义（χ2=39.95，P＜0.05；χ2=27.80，P＜0.05）；2009年与2010年比较，手术切口感染率差异无统计学意义（χ2=0.02，P＞0.05）。2009年与2008年、2010年与2008年、2010年与2009年比较，Ⅰ类手术切口感染率降低，但差异无统计学意义（χ2=2.83，P＞0.05；χ2=2.21，P＞0.05；χ2=0.05，P＞0.05）。 结论 推行PDCA循环管理模式，促进了消毒供应中心的规范化管理，实现了消毒器械质量控制的前馈控制、过程控制以及反馈控制；拓展了消毒供应专业领域，使医院的现有资源得到了最为高效的利用；使患者安全得到了切实保障。
ObjectiveTo discuss the application and effect of PDCA cycle in urgent values management in surgical intensive care unit. MethodsWe analyzed the quality of 141 cases of urgent value reports in surgical intensive care unit from May to July 2013 before the application of PDCA management. The quality of urgent values were totally controlled by PDCA circle. There were 135 cases of urgent value reports after the use of PDCA cycle. The data including qualify rate of specimens, record specification rate, and handover of urgent values were compared between the two groups of urgent values. ResultsAfter the application of PDCA cycle management, the awareness rate of urgent value content and disposal processes among medical staffs increased from 75% to 95%, with significant improvement in the quality rate of samples, recording and processing of urgent values and the quality rate of recording. ConclusionThe application of PDCA circle management can constantly correct the problems and ensure the policy implementation in the urgent values system in clinical departments, which can promote continuous quality improvement.
ObjectiveTo study the effects of PDCA cycle in the control of surgical site infection (SSI). MethodsA total of 1 761 surgeries between January 2012 and December 2013 were chosen to be monitored. PDCA cycle was used as a tool of total quality management evaluation to enhance the control of SSI. ResultsAfter 2 to 4 cycles of PDCA, the preventive medication rate of ClassⅠ operation incision was decreased significantly (χ2=309.513，P<0.001) and the postoperative incision infection rate did not change significantly (χ2=1.474，P=0.669). ConclusionUsing PDCA cycle can increase SSI management level and quality significantly and total quality management can be operated effectively.
ObjectiveTo analyze the effectiveness of PDCA cycle model in antibiotics management by comparison of antibiotics use before and after the use of PDCA in a tertiary hospital. MethodsProspective study was adopted to analyze the using rate of antibiotics in outpatients, emergent patients and inpatients between June 2011 and December 2013. ResultsThe reasonable antibiotics use was improved since the beginning of PDCA cycle model. The antibiotics using rates of outpatients were 33.00%, 29.09% and 19.31%, of emergent patients were 45.00%, 32.81% and 28.94%, and of inpatients were 71.00%, 57.76% and 53.28% in year 2011 (from June to December), 2012 (from January to December) and 2013 (from January to December) respectively. Meanwhile, ClassⅠ incision antimicrobial use also decreased and bacteria examination rate continuously increased during the last three years. As a consequence, patients' cost was reduced. ConclusionThe PDCA cycle model promotes the standardized management of clinical medication application.
ObjectiveTo investigate the effect of PDCA cycle on the overall nursing care of patients in the hemodialysis center. MethodsTwenty hemodialysis patients between June and July 2014 were randomly selected as the intervention group, and another 20 hemodialysis patients between March and April 2014 were chosen as the control group. We compared the two groups of patients in terms of patients' satisfaction and the overall care quality of the nurses. ResultsOne month after the intervention, patients in the intervention group had a significantly higher satisfaction rate than the control group (P<0.05); Nurses in the intervention group achieved significantly higher scores in basic requirements, basic items and effect evaluation than those in the control group (P<0.05). ConclusionPDCA cycle can effectively improve the overall quality of nursing care in hemodialysis center and improve patients' satisfaction.
ObjectiveTo explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals. MethodsIn the October 2014, PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality. We collected quality problems existing in the medical activities actively, analyzed the reason and influencing factors and made corresponding plans. Then we implemented the plans and measures strictly, surveyed the results, found out and analyzed the problems, summarized the results of the examination, and turned the unsolved problems to the next PDCA circulation. Continuous follow-up was performed until the results were satisfactory. Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard, we analyzed the medical quality of the hospital before PDCA application (July to September 2014) and after PDCA application (October to December 2014). ResultsThe incidence of medical nursing documents writing defects decreased from 12.4% to 5.9%. Hospital infection management defect rate declined from 13.5% to 5.3% and drug safety management defect rate declined from 11.8% to 2.5%, and all the differences were statistically significant (P<0.05). ConclusionPDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.
ObjectiveTo explore medical waste management method in a large hospital and strengthen the standardized management of medical waste. MethodsBetween July 2012 and December 2014, according to the PDCA cycle working procedures, existing problems were found in medical waste management through survey, the cause of which was analyzed to formulate and implement a new system of medical waste management, to help carry out employee training and cross examination, and give feedback to clinical departments to make improvements. Then, we analyzed the awareness rate of medical waste-related knowledge among medical staff, accuracy rate of medical waste disposal, average daily medical waste amount before and after the application of PDCA cycle to evaluate the effect of the measures taken. ResultsAwareness rate of medical waste-related knowledge among medical staff (2012:55.59%, 2013:62.89%, 2014:94.43%) increased with statistical significance (χ2=410.871, P<0.001). Accuracy rate of medical waste disposal (2012:69.83%, 2013:87.29%, 2014:94.91%) increased with statistical significance (χ2=197.449, P<0.001). Rank correlation analysis showed that average daily medical waste amount declined as average daily inpatients number increased (rs=?0.590, P<0.001). ConclusionUsing PDCA cycle can improve the awareness rate of medical waste-related knowledge and accuracy among medical staff to achieve continuous quality improvement of medical waste management.
ObjectiveTo study the effect of PDCA cycle model on the standardization of the application of common disinfectants, in order to promote the management level of hospital disinfection. MethodsBy questionnaire and observation, the study was to learn the knowledge and its application in medical workers on common disinfectants. Based on the results, we tried to regulate effective preventive measures and carry out continuous improvements. ResultAfter the implementation of PDCA cycle model, the awareness rate of the medical staff on disinfection and the application accuracy of disinfectants were significantly increased (P<0.05). ConclusionThe implementation of PDCA cycle model can improve nosocomial infection management level effectively, ensure medical quality management and patients' safety, which is an effective way of management to reduce the rate of nosocomial infection.
Objective To analyze the main problem of continuous hand hygiene improvement by PDCA cycle, find out the causes and carry out corresponding measures, in order to improve hand hygiene management continuously. Methods Between January and June 2014, PDCA cycle was used to strengthen comprehensive training, enhance awareness of hand hygiene, reinforce supervision, and evaluate the effect of continuous hand hygiene improvement. The knowledge of hand hygiene, increase of hand hygiene facilities, use of hand hygiene products and hand hygiene implementation before (from July to December 2013) and after PDCA application (from January to June 2014) were compared and analyzed. Results After the implementation of PDCA cycle, the pass rate of hand hygiene knowledge increased from 61.0% to 88.3%; the total amount of hand hygiene use increased from 1 817 046 mL to 3 347 386 mL; the hand hygiene compliance rate increased from 43.03% to 71.31%; and the correct rate of hand hygiene implementation increased from 62.68% to 87.68%. All the above differences were statistically significant (P<0.05). After the implementation of PDCA cycle, the compliance rate of different hand hygiene indications became significantly different (P<0.05). The growth rate of hand hygiene implementation before aseptic manipulation and after contact with body fluids were relatively higher (34.56% and 34.01%, respectively). Conclusion Through the application of PDCA cycle, hand hygiene compliance rate and correct rate have gradually increased.