科特的八步变化模型,以改善重症监护室的手部卫生遵守:一个41个月的前性纵向质量改善研究
1Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Clinical Research Center for Critical Care Medicine, Wuhan, Hubei, China; Hubei Engineering Center for Infectious Disease Prevention, Control and Treatment, Wuhan, Hubei, China.
科特的变化模型显著提高了重症监护室 (ICU) 的手部卫生遵守率,从35.71%提高到87.75%. 这一框架有效地改善了HHC并减少了感染.
科学领域:
- 医疗保健管理的管理
- 预防和控制感染的预防和控制.
- 组织变革 组织变革
背景情况:
- 尽管进行了各种干预措施,但手部卫生 (HHC) 仍然不足以达到最佳水平.
- 重症监护室 (ICU) 需要加强感染控制策略.
- 科特的变革模型 (KCM) 为组织变革提供了一个框架.
研究的目的:
- 实施科特的变化模型 (KCM) 以改善ICU中的HHC.
- 在医务人员中对KCM对HC的影响进行过程评估.
- 评估KCM对医疗保健相关感染的影响.
主要方法:
- 从2018年3月到2021年8月在ICU中实施KCM.
- 在41个月的时间里,对HHC进行了纵向监测.
- 对HHC趋势,感染率 (CLABSI,CAUTI) 和KCM阶段的分析.
主要成果:
- 总体而言,HHC从KCM实施后的35.71%增加到87.75%,增长了145.73%.
- 在患者接触后,HHC出现了快速增长,从35.29%增至89.8%.
- 尽管患者复杂性增加,但CLABSI和CAUTI的季度率仍然很低.
结论:
- 肯德基医疗卫生系统地改变了医疗保健提供者对手部卫生的看法.
- KCM促进了一个可持续的环境,以改善ICU中的HHC.
- 康复医学是改善高血压和减少感染的有效框架.
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