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目的:探讨PDCA循环质量管理模式在预防血库医源性感染的临床效果,提高医院血液应用的安全性。方法:2015年5月上虞人民医院中心血库引入PDCA循环质量管理模式进行质量管理,将2014年5月-2015年4月设置为对照时段,作为未实施PDCA管理前时段,将2015年5月-2016年4月设置为观察时段,作为实施PDCA管理后时段。比较两个时段血库预防医源性感染的相关指标(抽查医护人员执行相关标准规程合格率、关键岗位沉降菌抽查合格率、关键表面菌落数合格率、医务人员职业暴露发生率、受血者感染性输血反应率)。结果:对照时段和观察时段的采血例数、医护人员数量及构成、受血者例数、医院质控部门SOP执行监督检查次数、关键岗位沉降菌抽查次数比较差异无统计学意义,具有可比性。观察时段医护人员执行SOP合格率、关键岗位沉降菌合格率及关键表面菌落数合格率均明显高于对照指端,组间比较差异有统计学意义(P<0.05)。观察时段医护人员职业暴露率和受血者感染性输血反应率均明显低于对照时段,组间比较差异有统计学意义(P<0.05)。结论:采用PDCA循环质量管理模式对血库进行质量管理,可有效降低医源性感染发生率,提高血液采集、储存、使用的安全性,医院血库应坚持该质量管理模式,更进一步提升用血安全性。
Objective: To explore the clinical effect of PDCA cycle quality management model in preventing iatrogenic infection in blood bank and to improve the safety of blood application in hospital. Methods: In May 2015, the Shangyu People’s Hospital Central Blood Bank was introduced into the PDCA cycle quality management mode for quality management. May 2014-April 2015 was set as the control period, which was regarded as the pre-PDCA management period, and the May 2015- April 2016 Set as observation period as period after PDCA management is implemented. Comparing the relevant indexes of blood bank preventive medicine source infection in two periods (sampling rate of qualified staff in implementing the relevant standard procedures, passing rate of random sampling of sedimentation bacteria in key posts, passing rate of key surface colonies, occupational exposure rate of medical staff, infection by blood recipients Sex Transfusion Response Rate). Results: There were no significant differences in the number of blood sampling, the number and composition of health care workers, the number of recipients, the number of SOPs supervised and performed by hospital quality control departments, and the number of spot check bacteria in the control and observation periods . During the observation period, the qualified rate of SOP, the pass rate of sedimentation in key posts and the passing rate of key surface colonies were significantly higher than those in control finger. The difference between the two groups was statistically significant (P <0.05). During the observation period, the occupational exposure rate of medical staff and the rate of infectious transfusion reactions in recipients were significantly lower than those in control period, with significant difference between the two groups (P <0.05). Conclusion: The PDCA cycle quality management model of blood bank quality management can effectively reduce the incidence of iatrogenic infection and improve blood collection, storage and use of safety, the hospital blood bank should adhere to the quality management model, to further enhance the safety of blood use Sex.