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目的应用六西格玛质量管理方案改善手术室医护人员手卫生依从性,从而达到降低手术室感染的目的。方法选取2013年10月-2014年11月进入医院手术室的326名医务人员为研究对象,将六西格玛质量管理应用于手术室医护人员的手卫生依从性改善,针对前期对医护人员手卫生依从性的调查,分析目前医护人员手卫生依从性低的原因,采取针对性措施,并进行质量监控;观察改善前后手术室医护人员手卫生依从率及正确洗手情况,比较改善前后手术室患者感染率。结果应用六西格玛质量管理改进前手术室医护人员洗手率为52.01%,正确使用六步洗手法的医护人员为47.60%;改进后医护人员洗手率为93.89%,93.47%的医护人员可以正确使用六步洗手法,差异均有统计学意义(P<0.05);改进后医护人员手部菌落数为(2.3±0.5)CFU/cm2,显著低于改进前的(7.1±2.8)CFU/cm2;改进后手术室感染发生率为4.40%,显著低于改进前的7.91%,差异均有统计学意义(P<0.05)。结论六西格玛质量管理可以明显改善手术室医护人员手卫生依从性,提高医护人员对手卫生的重视度,减少手术室感染的发生。
Objective To improve the hand hygiene compliance of operation staff in the operating room by using Six Sigma quality management program so as to reduce the infection in the operating room. Methods A total of 326 medical staff who entered the operating room of the hospital between October 2013 and November 2014 were selected as research objects. Six Sigma quality management was applied to improve the hand hygiene compliance of operating staff in the operating room. , And analyzed the reasons for the low compliance of hand hygiene in medical staff at present, and took targeted measures and quality control; observed the compliance rate of hand hygiene staff in the operating room before and after the operation and the correct hand-washing status, and compared the patients’ infection rate before and after the operation room improvement. Results Applying Six Sigma to improve the hand hygiene rate of doctors and nurses in the former operating room was 52.01%, 47.60% were correctly using the six-step hand-washing method, 93.89% of the medical staff improved after the improvement, and 93.47% of the medical staff could correctly use six steps (2.3 ± 0.5) CFU / cm2, which was significantly lower than that of pre-treatment (7.1 ± 2.8) CFU / cm2. After the improvement The incidence of operating room infection was 4.40%, significantly lower than the 7.91% before improvement, the difference was statistically significant (P <0.05). Conclusion Six Sigma quality management can significantly improve the hand hygiene compliance of operating room staff, improve the health care staff’s emphasis on hand hygiene and reduce the incidence of operating room infection.