本文選題：品管圈　切入點：手衛(wèi)生　出處：《石河子大學》2014年碩士論文

【摘要】：目的：調(diào)查兵團農(nóng)八師某兩所醫(yī)院醫(yī)護人員手衛(wèi)生認知度現(xiàn)狀及影響其執(zhí)行手衛(wèi)生的相關因素，，并進一步探討品管圈在提高醫(yī)護人員手衛(wèi)生依從性中的作用，為基層醫(yī)院做好手衛(wèi)生管理提供依據(jù)。 方法：采用了分層整群抽樣方法，使用自擬《醫(yī)護人員手衛(wèi)生認知度調(diào)查表》，對所選醫(yī)院具有代表性科室的醫(yī)護人員進行問卷調(diào)查，了解醫(yī)護人員手衛(wèi)生認知度及影響其執(zhí)行的相關因素，探討品管圈作用時，首先實施品管圈活動，按照PDCA循環(huán)計劃、實施、確認、處置進行持續(xù)質(zhì)量改進，比較評價活動的有形和無形。 結果：本研究手衛(wèi)生知識滿分為14分，平均分為13.64±1.01分。醫(yī)護人員中，女性手衛(wèi)生知識知曉率高于男性，差異有統(tǒng)計學意義（χ2=6.5,P=0.011,P0.05）；不同科室的醫(yī)護人員手衛(wèi)生知識知曉率不全相同（χ2=16.1,P=0.003,P0.05)，其中監(jiān)護病房的醫(yī)護人員知曉率最高，為93.8%，最低的門診醫(yī)護人員，為72.3%，其余科室醫(yī)護人員知曉率均在80%左右。不同學歷的醫(yī)護人員手衛(wèi)生知識知曉率存在統(tǒng)計學差異（χ2=9.4,P=0.025,P0.05），其中知曉率最高的是碩士及以上學歷的醫(yī)護人員，為86.3%，最低的是本科學歷人員，為77.7%。醫(yī)護人員應執(zhí)行手衛(wèi)生次數(shù)為2506次,實際執(zhí)行手衛(wèi)生次數(shù)467次，手衛(wèi)生執(zhí)行率為18.64%。手衛(wèi)生依從性最好的科室是ICU醫(yī)護人員，執(zhí)行率為39%。其次為肝膽外科、呼吸內(nèi)科、麻醉科的醫(yī)護人員，執(zhí)行率分別是26.32%、20.69%、20%。手衛(wèi)生依從性最差的是兒科醫(yī)護人員，執(zhí)行率僅為4.76%，急診科室醫(yī)護人員執(zhí)行率不足10%，其余科室醫(yī)護人員手衛(wèi)生執(zhí)行率均在15%左右。影響醫(yī)護人員手衛(wèi)生執(zhí)行的影響因素中，清潔劑、消毒劑刺激皮膚，引起皮膚的干燥所占比例最高，占58.6%。92.1%的醫(yī)護人員認為選擇優(yōu)質(zhì)的速干手消毒劑，可以減少損傷皮膚的顧慮，從而提高手衛(wèi)生依從性。通過開展品管圈活動，科室醫(yī)護人員手衛(wèi)生依從性由改善前12.23％提高至28.08％，達到了設定的19.40%目標值；醫(yī)護人員在質(zhì)量改善手法的認識、自信心、溝通與協(xié)調(diào)能力、解決問題的能力、團隊凝聚力等方面有較大提升。 結論：醫(yī)護人員手衛(wèi)生知識知曉率較高，但手衛(wèi)生依從性較低，通過品管圈活動進行持續(xù)質(zhì)量改進，可有效提高醫(yī)護人員手衛(wèi)生意識及其依從性，同時應強化對手衛(wèi)生執(zhí)行的督導及培訓，改善手衛(wèi)生設施，實行獎懲結合的管理方法，從而提高手衛(wèi)生依從性。
[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 鹵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.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.3

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