Clinical effect of application of PDCA on reducing the incidence of healthcare-associated infection in department of neurosurgery / 中国感染控制杂志

Objective To study the effect of application of plan-do-check-act (PDCA) on reducing the incidence of healthcare-associated infection(HAI) in department of neurosurgery.Methods Quality control circle activity group was established,programme of activities was formulated,four stages and ten steps of PDCA were adopted,incidences of H AI in department of neurosurgery before (September-November 2015) and after (May-July 2016) the implementation of PDCA were observed,causes were analyzed based on implementation of hand hygiene,aseptic technique manipulation,and environmental sanitation,countermeasures were found out,and continuous quality improvement was performed for 6 months.Results Comparison between before and after implementation of PDCA was conducted,incidence of HAI in department of nerosurgery decreased from 10.9％ to 5.8％,difference was significant(P＜0.05),control rate was 100％,incidence of HAI dropped by 46.8％;hand hygiene implementation rate increased from 27.2％ to 76.9％,aseptic technique implementation rate increased from 76.0％ to 96.9％,environmental sanitation increased from 51.0 ％ to 90.0 ％,differences before and after implementation were all statistically significant(all P＜0.001).Conclusion Quality control circle activities implemented jointly by multiple departments can reduce the incidence of HAI in department of neurosurgery,rules can be observed,measures can be further improved,it is worthy of clinical application.

Fusion,complementary,fine selection:all thinking about the current status of comprehensive treatment in patients with hepatobiliary or pancreatic tumor / 中华肝胆外科杂志

Comprehensive treatment is an important treatment for unresectable or recurrent multiple tumors under the background of surgical and technical development.Medical treatments for patient should be applied individually and high selectively according to their own situation, and should also emphasize the key role of clinical specialized physicians. The situation what we worry about is that the imaging or interventional technicians have many problems to chose or conduct comprehensive treatment independently.Solution: Make the departments of surgery, inter medicine and relative medical technique unit as an entirety for cooperation, complementary and fine selection. In this mater, we will neither miss the chance of surgery nor effective comprehensive treatment. Overall, we should reinforce the management of patient and help them to release pain and prolong their survival.