品管圈在提高医护人员手卫生依从性的应用研究

发布时间：2018-03-26 08:20

本文选题：品管圈　切入点：手卫生　出处：《石河子大学》2014年硕士论文

【摘要】：目的：调查兵团农八师某两所医院医护人员手卫生认知度现状及影响其执行手卫生的相关因素，，并进一步探讨品管圈在提高医护人员手卫生依从性中的作用，为基层医院做好手卫生管理提供依据。方法：采用了分层整群抽样方法，使用自拟《医护人员手卫生认知度调查表》，对所选医院具有代表性科室的医护人员进行问卷调查，了解医护人员手卫生认知度及影响其执行的相关因素，探讨品管圈作用时，首先实施品管圈活动，按照PDCA循环计划、实施、确认、处置进行持续质量改进，比较评价活动的有形和无形。结果：本研究手卫生知识满分为14分，平均分为13.64±1.01分。医护人员中，女性手卫生知识知晓率高于男性，差异有统计学意义（χ2=6.5,P=0.011,P0.05）；不同科室的医护人员手卫生知识知晓率不全相同（χ2=16.1,P=0.003,P0.05)，其中监护病房的医护人员知晓率最高，为93.8%，最低的门诊医护人员，为72.3%，其余科室医护人员知晓率均在80%左右。不同学历的医护人员手卫生知识知晓率存在统计学差异（χ2=9.4,P=0.025,P0.05），其中知晓率最高的是硕士及以上学历的医护人员，为86.3%，最低的是本科学历人员，为77.7%。医护人员应执行手卫生次数为2506次,实际执行手卫生次数467次，手卫生执行率为18.64%。手卫生依从性最好的科室是ICU医护人员，执行率为39%。其次为肝胆外科、呼吸内科、麻醉科的医护人员，执行率分别是26.32%、20.69%、20%。手卫生依从性最差的是儿科医护人员，执行率仅为4.76%，急诊科室医护人员执行率不足10%，其余科室医护人员手卫生执行率均在15%左右。影响医护人员手卫生执行的影响因素中，清洁剂、消毒剂刺激皮肤，引起皮肤的干燥所占比例最高，占58.6%。92.1%的医护人员认为选择优质的速干手消毒剂，可以减少损伤皮肤的顾虑，从而提高手卫生依从性。通过开展品管圈活动，科室医护人员手卫生依从性由改善前12.23％提高至28.08％，达到了设定的19.40%目标值；医护人员在质量改善手法的认识、自信心、沟通与协调能力、解决问题的能力、团队凝聚力等方面有较大提升。结论：医护人员手卫生知识知晓率较高，但手卫生依从性较低，通过品管圈活动进行持续质量改进，可有效提高医护人员手卫生意识及其依从性，同时应强化对手卫生执行的督导及培训，改善手卫生设施，实行奖惩结合的管理方法，从而提高手卫生依从性。
[Abstract]:Objective: to investigate the status of hand hygiene awareness of medical and nursing staff in two hospitals and the related factors affecting their hand hygiene, and to explore the role of quality control circle in improving the hand hygiene compliance of medical and nursing staff. To provide the basis for the management of hand hygiene in primary hospitals. Methods: the stratified cluster sampling method was used to investigate the medical and nursing staff in the representative departments of the selected hospital. To understand the recognition of hand hygiene and the related factors affecting the implementation of the quality control ring, the first step is to implement the quality control circle activity, according to the PDCA cycle plan, to confirm the continuous quality improvement of the quality control ring. Compare the tangible and intangible aspects of evaluation activities. Results: the full score of hand hygiene knowledge in this study was 14, with an average score of 13.64 卤1.01. The awareness rate of hand hygiene knowledge in women was higher than that in men. The difference was statistically significant (蠂 ~ 2 ~ (6. 5) / P ~ (0.011) P ~ (0.05)), and the awareness rate of hand hygiene knowledge of medical and nursing staff in different departments was not all the same (蠂 ~ (21) 16.1 / P ~ (0.003) P ~ (0.05)). Among them, the rate of awareness of medical and nursing staff in the guardianship unit was the highest (93.8), and the lowest was in the outpatient department. The awareness rate of medical and nursing staff in other departments was about 80%. There was statistical difference in the awareness rate of hand hygiene knowledge among the medical and nursing staff with different degrees of education (蠂 2 9.4%, P 0.025%, P 0.05%), and the highest awareness rate was among the medical staff with master's degree or above. The medical staff should perform hand hygiene 2506 times, the actual hand hygiene times 467 times, the hand hygiene execution rate 18.64. The department with the best compliance of hand hygiene is the ICU medical staff, the lowest one is the undergraduate education staff, and the lowest one is 77.70.The number of hand hygiene should be 2506 times, the actual hand hygiene times 467 times, and the hand hygiene execution rate 18.64%. The execution rate was 39. The next was the medical and nursing staff in hepatobiliary surgery, respiratory medicine, and anesthesiology, and the execution rate was 26.320.690.The worst compliance in hand hygiene was for pediatric medical and nursing personnel. The execution rate was only 4.76%, the emergency department staff's execution rate was less than 10%, and the other departments' hand hygiene execution rate was about 15%. Among the influencing factors affecting the medical staff's hand hygiene execution were cleaning agents and disinfectants to stimulate the skin. The proportion of skin dryness was the highest, accounting for 58.6% and 92.1% of the medical staff thought that the choice of high-quality quick-drying hand disinfectant could reduce the concern of damaging skin and improve the hand hygiene compliance. The hand hygiene compliance of medical staff in the department was increased from 12.23% to 28.08, which reached the target value of 19.40%. Team cohesion and other aspects have been greatly improved. Conclusion: the awareness rate of hand hygiene knowledge is higher, but the hand hygiene compliance is low. Continuous quality improvement through quality control activities can effectively improve the hand hygiene awareness and compliance of medical staff. At the same time, we should strengthen the supervision and training of hygienic execution of opponents, improve hand hygiene facilities, and implement the management method of combining rewards and punishments so as to improve the compliance of hand hygiene.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.3

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