运用PDCA预防与控制住院患者多重耐药菌感染的成效

Effect of PDCA on preventing and controlling multidrug-resistant orga-nism infection in hospitalized patients

摘要:

目的 运用质量管理工具PDCA干预多重耐药菌感染的管理成效，以及在疾病诊断相关分组/按病种分值付费（DRG/DIP）收费模式下对医疗机构的影响。 方法 回顾性收集某三甲医院2021年11月1日—12月31日多重耐药菌感染预防与控制措施落实情况，以及多重耐药菌感染高发科室的感染相关指标。2022年3月1日—4月30日采用PDCA进行干预，对比干预前后多重耐药菌感染预防与控制措施落实率、多重耐药菌感染发生率、平均住院日、平均住院费用。 结果 PDCA干预前后多重耐药菌感染预防与控制措施落实率由61.94%提高至88.35%，干预后各多重耐药菌感染高发科室多重耐药菌感染发生率、平均住院日、平均住院费用较干预前均出现不同程度下降，差异均具有统计学意义（均P<0.05）。 结论 科学使用PDCA能够提高多重耐药菌感染预防与控制措施落实率，降低医院感染发生率及平均住院费用，缩短平均住院日，能避免在DRG/DIP收费模式下医疗机构出现医疗费用亏损的案例。

Abstract:

Objective To understand the management effectiveness of the intervention in multidrug-resistant organism (MDRO) infection through quality management tool plan-do-check-act (PDCA), and evaluate the impact in healthcare institutions under the diagnosis-related group/diagnosis-intervention packet (DRG/DIP) charging model. Methods The implementation of the prevention and control measures for MDRO infection in a tertiary first-class hospital from November 1 to December 31, 2021, and the infection-related indicators of the departments with high MDRO infection incidence were collected retrospectively. From March 1 to April 30, 2022, PDCA was adopted for intervention. The implementation rate of the prevention and control measures for MDRO infection, the incidence of healthcare-associated infection (HAI), the average length of hospital stay, and the average expense of hospitalization before and after the intervention were compared. Results The implementation rate of prevention and control measures for MDRO infection before and after PDCA intervention increased from 61.94% to 88.35%. After PDCA intervention, the incidence of MDRO HAI, the average length of hospital stay and the average hospitalization expenses of departments with high incidence of MDRO infection decreased compared with those before the intervention, with statistically significant differences (all P < 0.05). Conclusion The scientific use of PDCA can improve the implementation rate of the prevention and control measures for MDRO infection, and decrease the incidence of HAI and the average hospitalization expenses, as well as shorten the average length of hospital stay, thus avoid medical expense loss in medical institutions under the DRG/DIP charging mode.