ABSTRACT
Objective To improve the compliance of nurses in ICU standard specimen collection of blood culture by six sigma quality management method, so as to improve the quality of blood culture sample submission, to ensure the accuracy of inspection results. Methods A total of 158 nurses in ICU from February 2016 to January 2017 were selected as the research objects. The six sigma quality management method was used to analyze the operation of blood culture samples collected by ICU nurses,and the improvement plan was worked out and implemented. The compliance rate of blood culture samples collected by nurses before and after implementation and the feedback information of laboratory about blood culture specimen quality were compared. Results Before the application of six sigma quality management method, the compliance rate of blood culture specimens collected by ICU nurses was 54.1％(152/281), and the compliance rate after improvement was 88.6％(271/306), and the difference was statistically significant (χ2=86.45, P<0.01). Among the factors influencing nurses' blood culture,the importance of blood culture was not enough, the operation process was not mastered, the relevant knowledge of blood culture was not mastered, and the allocation of related consumables was unreasonable. After implementation,the composition ratio was reduced from 50.4％(65/129), 24.0％(31/129), 45.7％(59/129), 21.7％(28/129) to 17.1％(6/35), 8.6％(3/35), 25.7％(9/35), 2.9％(1/35), and the difference was statistically significant (χ2=4.00- 12.39, P<0.01 or 0.05). The contamination rate of blood culture specimens after six sigma management was 6.2％(19/306) and significantly lower than that of 16. 4％(46/281) before implementation,and the difference was statistically significant (χ2=15.36, P<0.01). Conclusions The six sigma quality management method can improve the nurses' attention to the correct collection of blood culture samples, reveal the defects in the operation, and reduce the irregular behavior of blood culture process. Therefore, the compliance of ICU nurses with standardized blood culture samples is improved, and the contamination rate of blood culture specimens is effectively reduced.