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实施六西格玛管理以规范外科手消毒操作

Implementation of six sigma management to standardize surgical hand disinfection practices.

作者信息

Jiang Ping, Liu Yan, Gu Hai-Yan, Li Qin-Xia, Xue Ling-Bo

机构信息

Department of Infectional Prevention and Control, Nantong First People's Hospital, No.666 of Shengli Road, Chongchuan District, Nantong, 226001, Jiangsu, China.

Department of Nursing, Nantong First People's Hospital, Jiangsu, 226000, China.

出版信息

BMC Surg. 2025 Mar 27;25(1):118. doi: 10.1186/s12893-025-02854-4.

Abstract

OBJECTIVE

The aim of this study is to evaluate the effectiveness of Six Sigma management in standardizing surgical hand disinfection practices among medical personnel.

METHODS

The Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) framework was utilized to assess and enhance the accuracy and effectiveness of surgical hand disinfection. Factors contributing to low accuracy and a high defect rate in disinfection practices were systematically analyzed. Key issues identified included limited awareness of infection control protocols, insufficient knowledge of proper surgical hand disinfection practices, and inadequate oversight of surgical staff. Interventions based on this analysis included the use of text and video reminders, reinforcement of medical personnel training, implementation of enhanced camera-based monitoring and supervision, and the establishment of a reward-and-penalty evaluation system.

RESULTS

Post-intervention analysis revealed that the accuracy of surgical hand disinfection among medical personnel increased from 42.94 to 82.97%, with surgeons demonstrating the greatest improvement, achieving a 47.70% increase. The overall defect rate decreased substantially, with the most notable reduction observed in incomplete hand coverage with disinfectant, which decreased by 2.75%. Additionally, the average number of bacterial colonies on the hands of medical staff decreased from 4.44 ± 2.51 CFU/cm to 2.68 ± 0.54 CFU/cm, and the qualification rate improved markedly from 71.67 to 98.33%. All observed improvements were statistically significant.

CONCLUSION

The application of Six Sigma management effectively enhances the accuracy and quality of surgical hand disinfection, reduces procedural defects, and enhances disinfection outcomes in clean surgical procedures.

摘要

目的

本研究旨在评估六西格玛管理在规范医务人员外科手消毒操作方面的有效性。

方法

采用六西格玛DMAIC(定义、测量、分析、改进、控制)框架来评估和提高外科手消毒的准确性和有效性。系统分析了导致消毒操作准确性低和缺陷率高的因素。确定的关键问题包括感染控制规程的认识有限、正确外科手消毒操作的知识不足以及对外科工作人员的监督不足。基于此分析的干预措施包括使用文本和视频提醒、加强医务人员培训、实施增强的基于摄像头的监测和监督以及建立奖惩评估系统。

结果

干预后分析显示,医务人员外科手消毒的准确性从42.94%提高到82.97%,外科医生的改善最为显著,提高了47.70%。总体缺陷率大幅下降,消毒剂手部覆盖不全的情况下降最为明显,下降了2.75%。此外,医务人员手部的平均菌落数从4.44±2.51 CFU/cm降至2.68±0.54 CFU/cm,合格率从71.67%显著提高到98.33%。所有观察到的改善均具有统计学意义。

结论

六西格玛管理的应用有效提高了外科手消毒的准确性和质量,减少了操作缺陷,增强了清洁手术过程中的消毒效果。

相似文献

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Surgical hand antisepsis to reduce surgical site infection.外科手消毒以减少手术部位感染。
Cochrane Database Syst Rev. 2016 Jan 22;2016(1):CD004288. doi: 10.1002/14651858.CD004288.pub3.

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