摘要
目的探讨精益管理在腹膜透析相关腹腔感染预防中的应用价值。方法将精益的方法与工具应用于腹膜透析相关腹腔感染预防中,比较实施精益管理前后各环节的操作合规率以及腹膜透析新置管患者相关腹腔感染发生率变化。并且调查精益实施前后患者满意度以及护士工作满意度的变化。结果实施精益管理后,腹膜透析置管术全流程操作总合规率由48.00%上升到84.00%(x^2=279.285,P=0.000);手卫生的执行率由43.14%上升到75.44%(P=0.001);新置管患者腹膜透析相关腹腔感染发生率由17.65%降至4.76%(P=0.030);患者满意度由改善前的(35.59±2.85)分上升到(43.43±2.36)分,腹膜透析护士工作满意度由(31.67±7.17)分提升至(43.42±3.90)分,差异均具有统计学意义(P<0.05)。结论精益管理应用在腹膜透析相关腹腔感染预防中,提高了全流程的操作合规率,降低了腹腔感染发生率,提升了患者满意度以及护士工作满意度,有进一步推广应用的价值。
Objective To investigate the effect of lean management in the prevention of infections from peritoneal dialysis.Methods Lean management and the tools were applied to prevent the infections from peritoneal dialysis.The operational compliance rates as well as the changes in the incidence of abdominal infection in peritoneal dialysis patients with new catheter were compared at various stages before and after lean implementation.The changes in patient satisfaction and nurses'job satisfaction before and after implementation were investigated.Results After implementation of lean management,the overall operational compliance rate in the whole process of peritoneal analysis catheterization increased from 48.00%to 84.00%(2=279.285,P=0.000);the hand sanitation rate increased from 43.14%to 75.44%(p=0.001).The incidence of peritoneal dialysis-related abdominal infection in the patients with new catheter decreased from 17.65%to 4.76%(P=0.030).The patient satisfaction increased from(35.59±2.85)to(43.43±2.36)after improvement.The peritoneal dialysis nurses'job satisfaction increased from(31.67±7.17)to(43.42±3.90)(P<0.05).There were statistical significant differences between pre-and post-implementation of lean management.Conclusion When used in peritoneal dialysis-related abdominal infection prevention,lean management tools can improve the operational compliance rate in the whole process,and reduce the incidence of abdominal infection.Meanwhile,lean management can improve patient satisfaction and nurses'job satisfaction.So,it is worth further popularizing and applying to clinical practice.
作者
张云
夏萍
侯铁英
高杨
田碧文
潘喜露
ZHANG Yun;XIA Ping;HOU Tieying;GAO Yang;TIAN Biwen;PAN Xilu(Dongguan Kanghua Hospital,Dongguan 523047,China)
出处
《现代医院》
2018年第3期341-344,349,共5页
Modern Hospitals
基金
东莞市社会科技发展一般项目(201850715059801)
关键词
精益管理
腹膜透析
感染预防
应用
Lean Management
Peritoneal Dialysis
Infection Prevention
Application
