ABSTRACT
Objective To evaluate the effect of plan-do-check-act (PDCA) cycle management method on improving multidrug-resistant organisms (MDROs) prevention and control measures.Methods PDCA cycle management method was applied to improve the management system and management process of a hospital,prevention and control efficacy of MDROs in clinic departments between July-December 2014 (before PDCA implementation) and January-June 2015 (after PDCA implementation) was compared.Results After half a year implementation of PDCA cycle management,the total implementation rate of MDROs prevention and control measures increased from 57.14％ (360/630) to 79.69％ (510/640),difference was statistically significant(P＜0.05);implementation rate of recording by doctors during the disease course,recording by nurses during the nursing process,registration and reporting of MDROs,as well as posting isolation signs were all improved,difference was statistically significant (all P＜0.05).The total isolation rate of MDROs declined from 30.65％ (347/1 132)before PDCA implementation to 22.61％ (236/1 044) after PDCA implementation,difference was statistically significant (x2 =10.393,P＜0.05).Conclusion Application of PDCA cycle can improve the prevention and control measures of MDROs.
ABSTRACT
<p><b>BACKGROUND</b>Laparoscopic liver resection has become an accepted treatment for liver tumors or intrahepatic bile duct stones, but its application in patients with previous upper abdominal surgery is controversial. The aim of this study was to evaluate the feasibility and safety of laparoscopic hepatectomy in these patients.</p><p><b>METHODS</b>Three hundred and thirty-six patients who underwent laparoscopic hepatectomy at our hospital from March 2012 to June 2015 were enrolled in the retrospective study. They were divided into two groups: Those with previous upper abdominal surgery (PS group, n = 42) and a control group with no previous upper abdominal surgery (NS group, n = 294). Short-term outcomes including operating time, blood loss, hospital stay, morbidity, and mortality were compared among the groups.</p><p><b>RESULTS</b>There was no significant difference in median operative duration between the PS group and the NS group (180 min vs. 160 min, P = 0.869). Median intraoperative blood loss was same between the PS group and the control group (200 ml vs. 200 ml, P = 0.907). The overall complication rate was significantly lower in the NS group than in the PS group (17.0% vs. 31.0%, P = 0.030). Mortality and other short-term outcomes did not differ significantly between groups.</p><p><b>CONCLUSIONS</b>Our study showed no significant difference between the PS group and NS group in term of short-term outcomes. Laparoscopic hepatectomy is a feasible and safe procedure for patients with previous upper abdominal surgery.</p>