Abstract：Objective: To monitor the specific data and classification of acquired infections in abdominal emergency surgery, to evaluate the main risk factors of hospital infections of abdominal emergency surgery, to improve the quality of target monitoring, and to formulate reliable preventive measures targeted to effectively reduce the occurrence of hospital infections. Methods: Through effective monitoring and analysis of the clinical data collected in 2016, the main types of infections found were analyzed by single-factor and multi-factor analysis to find the risk factors of infection, and PDCA management was carried out.The task was expected to be completed in 2019. Statistics of relevant data were conducted through SPSS19.0 to confirm the effectiveness of PDCA. Results: In 2016, the incidence of general hospital infections was 7.91%, with surgical site infection (SSI) as the main type of infection, accounting for 3.6%. Through the collection and analysis of clinical data, it was found that the susceptibility factors of SSI are: The incidence of SSI with NNIS score ≥ 3 is higher than that with NNIS score <3; the difference was statistically significant (χ2=12.687, P<0.05). The incidence of SSI with irrational use of antimicrobials before surgery is higher than that of SSI with reasonable use of antimicrobials before surgery; the difference was statistically significant (χ2=9.092, P<0.05). The incidence of SSI with operation time ≥3h is higher than that with operation time <3h; the difference was statistically significant (χ2=9.087, P<0.05). Through the precise application of PDCA management, the incidence of SSI in 2019 dropped significantly from 3.6% to 1.33% (χ2=3.565, P<0.05).Conclusion: NNIS score ≥3, and irrational use of antimicrobials before surgery can be risk factors for infection of the surgical site. Effective PDCA management for the main risk factors mentioned above can effectively reduce the incidence of SSI.
唐冠杰, 池水晶, 孙志德. 精准应用PDCA管理工具降低腹部急诊外科住院患者主要医院感染发生率[J]. 河北医学, 2021, 27(1): 71-74.
TANG Guanjie, CHI Shuijing, SUN Zhide. Accurate Application of PDCA Management Tools to Reduce the Incidence of Major Nosocomial Infections in Abdominal Emergency Patients. HeBei Med, 2021, 27(1): 71-74.
[1] 沈新芬,顾明宏,郑红春,等.PDCA循环联合营养支持对有机磷中毒患者心理睡眠质量及生命质量的影响研究[J].中国预防医学杂志,2020,21(6):709~714. [2] 宋军红.35例心脏外科患者手术部位感染的危险因素分析及其对策[J].感染与预防,2019,16(11):1904~1906. [3] 中华医学会外科学分会外科感染与重症医学学组,中国手术部位感染预防指南[J],中华胃肠外科杂志,2019,11(4):301~314. [4] 黄新玲,郑丽英,何文英,等.肥胖对结直肠癌手术部位感染的影响[J].中国感染控制杂志,2016,14(12):837~839. [5] 叶慧,宗志勇,吕晓菊.2017年版美国疾病预防控制中心手术部位感染预防指南解读[J].中国循证医学杂志,2017,12(7):745~750. [6] Thangaraju Pugazhenthan,Venkatesan Sajitha. Responding to the global guidelines for the prevention of surgical site infection, 2018: a focus on surgical antibiotic prophylaxis prolongation.[J]. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences,2019,24(12)201~209. [7] 瞿介明,施毅.中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)的更新与解读[J].中华结核和呼吸杂志,2018,8(4):244~246. [8] 游灿青,李凌竹,查筑红,等.贵州省118所医院的医院感染质量控制指标调查分析[J].中华医院感染学杂志,2016,22(17):4073~4076.
2021, Vol. 27 
冀公网安备13080202000677号