Objective To know the present situation of hand hygiene compliance in medical staff and analyze problems in the management of hand hygiene and related influencing factors, in order to take effective control measures and gradually improve hand hygiene compliance in medical staff. Methods Between January and October 2014 and between January and October 2015, 8-10 healthcare workers respectively from Department of Internal Medicine, Department of Surgery and Department of Rehabilitation were selected to be observed. The healthcare workers between January and October 2014 before the application of plan-do-check-action (PDCA) cycle were regarded as the control group, and hand hygiene observation was performed in October 2014; the healthcare workers between January and October 2015 were regarded as the observation group (after PDCA application), and hand hygiene observation was carried out in October 2015. Under the PDCA cycle, we set up hand hygiene management working group to investigate the hand hygiene work before PDCA cycle was applied. Hand hygiene knowledge survey was carried out. Fishbone diagram was used to find out the causes of poor hand hygiene compliance. Based on these factors, improvement plans of hand hygiene were regulated and implemented. Then, continuous improvement was promoted according to PDCA cycle management process. Results After PDCA implementation, healthcare workers’ hand hygiene compliance (79.67%), correct handwashing rate (94.97%), and hand hygiene compliance before contacting the patients (85.96%), before sterile operation (68.14%), after contacting the patients (78.02%), after contacting patients’ blood or body fluid (85.96%), and after contacting patients’ surroundings (79.14%) were all significantly higher than those before the PDCA implementation (46.39%, 69.62%, 38.42%, 23.20%, 49.14%, 53.78% and 48.39%) (P<0.05). After the implementation of PDCA cycle, the amount of disinfectants consumed per day and the amount of hand sanitizer was 10.13 mL, significantly more than that before PDCA implementation (2.8 mL). The hospital was equipped with full hygiene equipment. Conclusion Applying PDCA cycle for continuous improvement of hand hygiene work can promote the hand hygiene compliance for medical staff.
【Abstract】ObjectiveTo investigate whether tumor necrosis factor-α (TNF-α) enhance the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9(MMP-9) in hepatic cancer cell line HepG2 or not. Methods Cultured HepG2 cells were treated by TNF-α with various concentration and time. The morphological changes of HepG2 cells were studied microscopically and the proliferation of HepG2 were detected by methyl thiazolyl tetrazolium (MTT). The expression of VEGF and MMP-9 mRNA in cultured HepG2 were determined by relative quantitative reverse transcription polymerase chain reaction. The VEGF and MMP-9 protein level in supernatants and in cytoplasm were determined by enzymelinked immunosorbent assay (ELISA) and by immunocytochemical staining, respectively.Results There was a little morphological changes in HepG2 with TNF-α treatment, but no change of cell proliferation in corresponding time. The expression of VEGF and MMP-9 mRNA was enhanced gradually with the TNF-α concentration increasing, the VEGF and MMP-9 protein level in supernatants and in cytoplasm was elevated gradually with the concentration increasing. There was a dependance on the concentration when the concentration of TNF-α was lower than or equal to 104 U/L. Furthermore, the effect of promotion was close to peak when the TNF-α concentration up to 104 U/L; but no timeeffect pattern observed. Conclusion TNF-αJP can enhance the expression of VEGF and MMP-9 at the level of mRNA and protein in hepatic cancer cell line.