Abstract:

Objective To evaluate the effect of lean management in the prevention and control of multidrug-resistant bacteria infections in hospitals. Methods　A total of 451 patients with multidrug-resista bacteria detected at First Affiliated Hospital of Guangdong Pharmaceutical University from January to June 2023 were selected as a control group, and 387 patients with multidrug-resistant bacteria detected from July to December 2023 were selected as an experimental group. There were 297 males and 154 females in the control group; they were (73.93±16.95) years old. There were 260 males and 127 females in the experimental group; they were (71.35±16.22) years old. The basic data were compared between the two groups. The implementation rates of core multidrug-resistant bacteria prevention and control measures and nosocomial infection rates were compared between before and after the implementation of lean management. The effect of lean management was assessed. t and χ² tests were used for the statistical analysis. Results　The execution rate of contact isolation, hand hygiene compliance rate, aseptic operation execution rate, qualified rate of cleaning and disinfection, and execution rate of core prevention and control measures in the experimental group were higher than those in the control group [96.90% (375/387) vs. 80.93% (365/451), 80.80% (324/387) vs. 60.58% (252/451), 82.95% (321/387) vs. 61.86% (279/451), 82.43% (319/387) vs. 65.63% (296/451), and 82.43% (319/387) vs. 54.17% (244/451)], with statistical differences (χ²=119.820, 40.145, 42.761, 17.836, and 53.101; all P<0.05). The awareness rates of multidrug-resistant bacteria prevention and control knowledge by doctors, nurses, and sanitation workers were 69.80% (245/351), 73.15% (436/596), and 50.25% (102/203) before the implementation of lean management; after the the implementation of lean management, the overall awareness rate was 90.60% (1 002/1 106) (all P<0.05). The incidence rate of multidrug-resistant bacteria nosocomial infections in the experimental group was lower than that in the control group [0.15% (33/21 619) vs. 0.29% (55/19 265)], with a statistical difference (χ²=8.717; P<0.05). Conclusion　The lean management mode is effective in the prevention and control of multidrug-resistant bacteria, and can reduce the occurrence of multidrug-resistant bacteria nosocomial infections.

Key words:

Multidrug-resistant, Lean management, Prevention and control measures

摘要：

目的　评估精益管理在医院多重耐药菌感染防控中的效果。方法　选择2023年1月至6月在广东药科大学附属第一医院检出的451例多重耐药菌患者作为对照组，2023年7月至12月检出的387例多重耐药菌患者作为试验组。对照组男297例、女154例，年龄（73.93±16.95）岁，实施精益管理前（常规管理）；试验组男260例、女127例，年龄（71.35±16.22）岁，实施精益管理后。对比两组患者基本情况，实施精益管理前后多重耐药菌核心防控措施执行率及医院感染发病率的变化，并评估精益管理效果。统计学方法采用t检验、χ²检验。结果　试验组接触隔离执行率、手卫生依从率、无菌操作执行率、清洁消毒合格率及多重耐药菌核心防控措施执行率均高于对照组［96.90%（375/387）比80.93%（365/451）、80.80%（324/387）比60.58%（252/451）、82.95%（321/387）比61.86%（279/451）、82.43%（319/387）比65.63%（296/451）、82.43%（319/387）比54.17%（244/451）］，差异均有统计学意义（χ²=119.820、40.145、42.761、17.836、53.101，均P<0.05）。精益管理前，医生和护士防控知识知晓率分别为69.80%（245/351）、73.15%（436/596），工勤人员仅为50.25%（102/203）；精益管理后，总体知晓率提高至90.60%（1 002/1 106）（均P<0.05）。试验组多重耐药菌医院感染例次率为0.15%（33/21 619），低于对照组的0.29%（55/19 265），差异有统计学意义（χ²=8.717，P<0.05）。结论　精益管理模式对多重耐药菌的防控有效，可有效降低多重耐药菌医院感染的发生。

关键词:

多重耐药, 精益管理, 防控措施