Abstract:

Objective　To observe the effect of quality control management based on cycle management method in improving hand hygiene of medical staff and preventing hospital infection. Methods　This was a retrospective study. According to the implementation time of quality control management based on cycle management method in the Third People's Hospital of Hubei Province Affiliated to Jianghan University, the period from January to June 2023 was before the implementation, and the period from July to December 2023 was after the implementation. The medical staff before and after the implementation were the same batch, including 23 females and 7 males, aged 21-47 (33.27±3.15) years; for education level, there were 2 college students, 25 undergraduates and 3 postgraduates. Before and after the implementation, the qualified rate of hospital environmental sample test, qualified rate of medical staff's hand hygiene, mastered rate of knowledge of infection control, mastered rate of hygiene and disinfection skills, management quality, and hand hygiene compliance were compared. Paired t test and χ² test were used. Results　After the implementation, the qualified rates of environmental samples collected from disinfectants in use and surface of a random object were higher than those before the implementation, but the differences were not statistically significant (both P>0.05). After the implementation, the qualified rates of medical staff's hand hygiene before and after contacting with patients, before cleaning or sterile operation, and after contacting with patients' surroundings and body fluids were higher than those before the implementation [96.67% (29/30) vs. 70.00% (21/30), 90.00% (27/30) vs. 60.00% (18/30), 56.67% (17/30) vs. 26.67% (8/30), 93.33% (28/30) vs. 70.00% (21/30), 96.67% (29/30) vs. 76.67% (23/30)] (all P<0.05). After the implementation, the scores of infection control knowledge and disinfection skills of medical staff were higher than those before the implementation [(87.56±5.24) points vs. (76.29±7.83) points, (91.27±3.11) points vs. (84.59±5.14) points] (both P<0.05). After the implementation, the scores of quality of environmental management, awareness of risk prevention, and safety identification ability of medical staff were higher than those before the implementation [(88.35±4.05) points vs. (79.52±6.18) points, (87.43±3.72) points vs. (76.82±5.59) points, (91.35±2.47) points vs. (83.98±4.16) points] (all P<0.05). After the implementation, the hand hygiene compliance rate of medical staff was higher than that before the implementation [70.38% (221/314) vs. 39.02% (119/305)] (P<0.05). Conclusion　Quality control management based on cycle management method can enhance the medical staff's compliance with hand hygiene and awareness of hospital infection prevention and control, thereby improving the quality of hospital infection prevention and control.

Key words:

Medical staff, Hand hygiene, Hospital infection, Cycle management method, Quality control management, Prevention, Effect

摘要：

目的　观察基于循环管理法的质控管理对医务人员手卫生改善及医院感染预防的效果。方法　本研究为回顾性研究。以江汉大学附属湖北省第三人民医院基于循环管理法的质控管理实施前后进行比较，2023年1月至6月为实施前，2023年7月至12月为实施后。实施前后均为同一批医务人员，共30名。女23名、男7名；年龄21～47（33.27±3.15）岁；文化程度：大专2名、本科25名、硕士研究生3名。比较实施前后院内环境样本检测合格情况，医务人员手卫生合格情况、感控知识掌握情况、卫生消毒技能掌握情况、管理质量、手卫生依从性。采用配对t检验和χ²检验。结果　实施后，使用中消毒液、随机物体表面的环境样本合格率均高于实施前，但差异均无统计学意义（均P>0.05）；医务人员接触患者前、接触患者后、清洁或无菌操作前、接触患者周围物品后、接触患者体液后手卫生合格率均高于实施前［96.67%（29/30）比70.00%（21/30）、90.00%（27/30）比60.00%（18/30）、56.67%（17/30）比26.67%（8/30）、93.33%（28/30）比70.00%（21/30）、96.67%（29/30）比76.67%（23/30）］（均P<0.05）；医务人员感控知识、卫生消毒技能评分均高于实施前［（87.56±5.24）分比（76.29±7.83）分、（91.27±3.11）分比（84.59±5.14）分］（均P<0.05）；医务人员环境管理质量、风险防范意识、安全识别能力评分均高于实施前［（88.35±4.05）分比（79.52±6.18）分、（87.43±3.72）分比（76.82±5.59）分、（91.35±2.47）分比（83.98±4.16）分］（均P<0.05）；医务人员手卫生依从率高于实施前［70.38%（221/314）比39.02%（119/305）］（P<0.05）。结论　基于循环管理法的质控管理可改善医务人员手卫生依从性和医院感染防控执行意识，提高医院感染防控工作质量。

关键词:

医务人员, 手卫生, 医院感染, 循环管理法, 质控管理, 预防, 效果