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Monthly hand hygiene compliance of before patient contact (a), before an aseptic task (b), after body fluid exposure risk (c), after patient contact (d), after contact with patient surroundings (e) and after removing gloves (f)
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Background
Hand hygiene is an important element of the WHO multimodal strategy for healthcare-associated infection control, whereas compliance of hand hygiene among healthcare workers (HCWs) remains a challenge to sustain. In order to increase the hand hygiene compliance of HCWs, a quality control circle (QCC) program was carried out in our hospita...
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Background
The General Health Questionnaire-12 (GHQ-12) is a widely used instrument to assess mental health status. However, little is known about its applicability in Chinese healthcare workers. This study aimed to evaluate the reliability and validity of the GHQ-12 in Chinese dental healthcare workers.
Methods
Dental healthcare workers participa...
Citations
... Quality control circle (QCC) is a comprehensive and scientific management model established following the "PDCA" (plan-docheck-act) process. [3] By the end of 2016, more than 40,000 QCC activities had been successfully carried out in China. [4] The positive role of QCC in patient management has been repeatedly approved in clinic. ...
... [4] The positive role of QCC in patient management has been repeatedly approved in clinic. [3,5,6] In order to enhance patient early ambulation after cesarean section, our hospital pulled in QCC activities from May to November 2019 and achieved great success, as introduced below. ...
Background
The quality control circle (QCC) model has achieved good results in clinical applications in many hospitals in China and has gained popularity. This study aims to explore the application of QCC activities on early ambulation after cesarean section.
Methods
A QCC management group was established following standardized methods and techniques. The theme of the group was identified as “to enhance the implementation rate of the patient early ambulation after the cesarean section” through a matrix graph. The early ambulation rates after surgery of patients who received cesarean section were compared before and after QCC managements.
Results
Our data suggested that the early ambulation rates after cesarean section increased from 37.5% to 81.25% after applying QCC management. The biggest factor influencing the ambulation activities 24 ± 4 hours after the surgery was patients and family members do not cooperate. In addition, outstanding improvements in terms of nurses’ sense of responsibility and self-confidence, communication and teamwork capacity in the problem-solving process were observed after the establishment of QCC.
Conclusion
The application of QCC management had not only increase the early ambulation rates after cesarean section but also improved the quality of nursery care in general.
... The proposal proved to play a critical role in improving the HH compliance of staff members in medical institutions. Other measures such as the adoption of a combination of the quality control circle and plan-do-check-act were also found to be effective [9]. Likewise, some studies have sought to maintain adherence via reminder mechanisms such as posters to improve HH [10,11], and an Internet-based tool to monitor and test the HH compliance of nursing and medical staff members also appears to be effective [12]. ...
My 5 moments (M5M) was used less frequently among cleaning staff members, suggesting that a poor compliance score in this group may not indicate deficient handwashing. This quasi-experimental study compared hand hygiene compliance (HHC), hand hygiene (HH) moments, and HH time distribution in the control group (no HH intervention; n = 21), case group 1 (normal M5M intervention; n = 26), case group 2 (extensive novel six moments (NSM) training; n = 24), and case group 3 (refined NSM training; n = 18). The intervention’s effect was evaluated after 3 months. The HHC gap among the four groups gradually increased in the second intervention month (control group, 31.43%; case group 1, 38.74%; case group 2, 40.19%; case group 3, 52.21%; p < 0.05). After the intervention period, the HHC of case groups 2 and 3 improved significantly from the baseline (23.85% vs. 59.22%, 27.41% vs. 83.62%, respectively; p < 0.05). ‘After transferring medical waste from the site’ had the highest HHC in case group 3, 90.72% (95% confidence interval, 0.1926–0.3967). HH peak hours were from 6 AM to 9 AM and 2 PM to 3 PM. The study showed that the implementation of an NSM practice can serve as an HHC monitoring indicator and direct relevant training interventions to improve HH among hospital cleaning staff.
... Dr. Kaoru Ishikawa of Japan, which is viewed as a powerful tool to solve the problems in work and improve the complex work ow by the joint efforts of all members composed of staff from the same or similar or complementary workplaces [11]. Until 2001, QCC activities was introduced to healthcare industry in China, and numerous studies have reveled that the application of QCC could effectively raise the quality of medical service and ensure the safety of patients [12][13][14]. Despite the extensive application of QCC in healthcare industry, few studies have formally determined its associateion with SAP. ...
Administration of surgical antimicrobial prophylaxis (SAP) is considered one of the most effective measures to reduce the incidence of surgical site infection (SSI) after various surgical procedures. Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in SAP remains unknown. Our present study utilized the QCC activity to improve the appropriate administration of SAP. A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. The appropriateness of SAP before (July to December 2018) and after (January to June 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The appropriate rate of SAP was significantly improved from 68.72% before QCC to 93.7% post QCC implementation ( P ༜0.01). A significant improvement ( P ༜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antimicrobial usage (from 96.8 to 99.41%), re-dosing of antimicrobial (from 96.55 to 99.21%). The appropriate application of SAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial misuse and overuse.
... Similarly, for the evaluation of sample cleanliness, the qualified rate of mobile phones of female HCWs was higher than that of males, and the qualified rate of nurses was higher than that of others. It could be explained that most participants were nurses, and they were mainly females, who were better performers of nosocomial infection control measures, such as hand hygiene [33]. A study conducted in East Ethiopia also found that mobile phones of male HCWs were more contaminated [34]. ...
Background
Mobile phones are widely used in clinical settings and could be colonized by potential pathogenic bacteria which may lead to hospital-acquired infections (HAIs) transmission. This study aimed to determine the prevalence of bacterial contamination of healthcare workers’ (HCWs) mobile phones, identify bacterial isolates, and assess the factors associated with mobile phone contamination.
Methods
Self-administered questionnaire was used to collect the information on the demographic characteristics and the use of mobile phones. A total of 111 HCWs’ hands and their mobile phones were swabbed, then bacterial culture, isolation, and identification were performed. Univariate and multivariable logistic regression were applied to identify factors associated with mobile phone bacterial contamination.
Results
Totally 106 (95.5%) of the 111 mobile phones investigated were contaminated with bacteria. Staphylococcus epidermidis (13/111), Acinetobacter baumannii (4/111) and Staphylococcus aureus (3/111) were the predominant bacterial isolates from HCWs’ mobile phones. Univariate analyses showed that age, gender, profession and the frequency of mobile phone utilization were significantly associated with the number of bacterial colonization. Frequency of phone utilization (OR 8.366; 95% CI 1.496–46.797) was found to be the most significant factors associated with the qualified rate of mobile phones bacterial load. In addition, phone cover using was associated with the increased risk of mobile phone bacterial contamination.
Conclusion
There was cross-contamination between hands and phones. It is necessary to develop guidelines for mobile phone cleaning. Special attention needs to be paid to the disinfection of mobile phone covers to reduce contamination and transmission of pathogens.
... HCWs were more likely to perform HH than males (85.6%) (both p < 0.001). Overall HH compliance and observance of the five indications exhibited significant linear increases over time (p < 0.005) [14]. We also used the QI methodology to improve HH compliance. ...
Background
Hospital-acquired infections (HAIs) are the most severe complications of intensive care stay, especially in pediatric patients. Proper hand hygiene (HH) is the cheapest, simplest, but often neglected method to prevent HAIs. The World Health Organization (WHO) has formulated and promoted a standardized recommendation for HH. Both the WHO and the Centers for Disease Control and Prevention (CDC) recommend the use of soap and water for handwashing whenever there is visible dirt on the hands. In all other situations, an alcohol-based hand rub is an effective alternative. The quality improvement (QI) methodology has been widely followed in many countries to improve basic and advanced healthcare systems. The QI strategy follows the plan-do-study-act (PDSA) method.
Methodology
This quasi-experimental (pre- and post-intervention), prospective, QI study was conducted at the neonatal intensive care unit and pediatric intensive care unit of the pediatrics department in a tertiary care hospital in Bihar, India. A QI team was formed. The study was divided into four phases. WHO charts for assessing HH compliance were used for observation and data collection. The EQUATOR Checklist (Squire Checklist) was used to accurately report the QI work. Epi Info™ (version 7.2.5) was used for statistical analysis. The chi-square test was used to measure the statistical difference between pre- and post-intervention HH compliance (proportions).
Results
In the pre-intervention phase, a total of 106 HH opportunities were observed. The HH compliance at this stage was 40.6%. The QI team conducted several meetings, and a root cause analysis was performed with the help of the Fishbone diagram. It was decided to target three probable causes, namely, (a) less awareness, (b) inconvenient locations of hand rub dispensers, and (c) forgetfulness. The QI team decided to run three PDSA cycles. In the last phase, 212 HH opportunities were observed with a compliance percentage of 69.8%. There was a significant improvement when data of pre- and post-intervention HH compliance were compared in all categories of healthcare workers (HCWs), except doctors, where the improvement was not statistically significant. When the cumulative data of all subtypes of HCWs were analyzed, there was a significant improvement (p < 0.0001). Run charts and box plots were used for the easy depiction of the results.
Conclusions
Adopting proper HH methods remains the most effective way of preventing nosocomial infections, especially in intensive care units. We used the WHO model of HH in our study. The pre-intervention HH compliance was 40.6%. QI methodology using root cause analysis and implementation of three PDSA cycles were used to increase the HH compliance percentage. Post-intervention HH compliance increased to 69.8% and the effect was sustained. The study highlights the usefulness of the QI methodology in bringing small but important changes in clinical practice for better patient care.
... Furthermore, in health care settings, there was a significant difference between self-reported and actual observational hand hygiene compliance. Hand hygiene compliance ranged from 50 to 76 percent in developed countries such as the United States, Canada, and China [27][28] [29][30] [31] . However, while self-reported hand hygiene compliance in European countries was around 50%, observational studies reported compliance as low as 36%. ...
Objective: The objectives of this study were to evaluate the compliance of hand hygiene among dental health care professionals, to access different variables associated with hand hygiene and to identify possible ways of improving hand hygiene compliance. Methods: This descriptive cross-sectional study was done to access the hand hygiene compliance, knowledge and practice of dental house officers in public dental institutes using a questionnaire developed by the authors. Descriptive statistics and chi square test were performed and a P value <0.05 was taken as significant. Results: 88 dental house officers working in different clinical departments participated in this study. 90% of the respondents believed that hand hygiene plays an important role in cross infection control. More than two-third were aware of all the steps recommended for hand washing, but more than half were not following them. 60% of the respondents wash their hands before and after touching each patient. However, 30% wash hands after each patient and 10% only wash hands before touching every patient. Fifty-five (55.8%) of the participants routinely use alcohol-based rub for hand hygiene. There was a significant difference regarding hand hygiene training among different departments. (p<0.001) Majority of house officers working in prosthodontics and surgery had not received hand hygiene training. Conclusion: Hand hygiene compliance is found to be acceptable when compared with developing countries. However, there was lack in knowledge. Dental graduates should be made aware of CDC and ADA guidelines. Better facilities and instruction for dental students should be encouraged. Hand hygiene quality needs to be improved on an urgent basis.
... Quality control circle (QCC) is a process management and problem-solving technique founded in 1962 by Dr. Kaoru Ishikawa of Japan, which is viewed as a powerful tool to solve the problems in work and improve the complex work ow by the joint efforts of all members composed of staff from the same or similar or complementary workplaces [11] . Until 2001, QCC activities was introduced to healthcare industry in China, and numerous studies have reveled that the application of QCC could effectively raise the quality of medical service and ensure the safety of patients [12][13][14] . In our present study, a QCC program was carried out to improve the rational application of surgical antimicrobial prophylaxis in clean surgery procedures, and the plan-do-check-act (PDCA) method was implemented for 12 months. ...
Background: Appropriate implementation of perioperative antimicrobial prophylaxis in surgery is considered an effective measure to prevent the incidence of surgical site infection and the emergence of antimicrobial-resistant bacteria. To reduce the emergence of antimicrobial-resistant bacteria, there is a need to improve the correct implementation of PAP.
Methods: A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. Results: The appropriate rate of PAP was significantly improved from 68.72% (n=406) before QCC to 93.7% (n=508) post QCC implementation (P＜0.01). A significant improvement (P＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%).
Conclusions: The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.
... Quality control circle (QCC) is a process management and problem-solving technique founded in 1962 by Dr. Kaoru Ishikawa of Japan, which is viewed as a powerful tool to solve the problems in work and improve the complex work ow by the joint efforts of all members composed of staff from the same or similar or complementary workplaces [11] . Until 2001, QCC activities was introduced to healthcare industry in China, and numerous studies have reveled that the application of QCC could effectively raise the quality of medical service and ensure the safety of patients [12][13][14] . In our present study, a QCC program was carried out to improve the rational application of surgical antimicrobial prophylaxis in clean surgery procedures, and the plan-do-check-act (PDCA) method was implemented for 12 months. ...
The present study aimed to exam the effect of quality control circle (QCC) activities on promoting the appropriate implementation of preoperative antibiotic prophylaxis in clean surgery. A QCC activity team was established to grasp the current situation of PAP in clean surgery procedure, set target, formulated corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The appropriateness of PAP before (July to December 2018) and after (April to September 2019) the implementation of QCC activities were evaluated based on relevant international and Chinese perioperative antimicrobial prophylaxis guidelines. The appropriate rate of PAP was significantly improved from 68.72% ( n =406) before QCC to 93.7% ( n =508) post QCC implementation ( P ＜0.01). A significant improvement ( P ＜0.05) was also determined for each category: selection (from 78.82 to 96.06%), duration (from 90.15 to 96.46%), indication (from 94.09 to 97.64%), timing of first dose (from 96.55 to 99.21%), antibiotic usage (from 96.8 to 99.41%), re-dosing of antibiotic (from 96.55 to 99.21%). The appropriate application of PAP is improved through QCC activities, providing a useful reference for the prevention of antimicrobial-resistant bacteria and the development of medical quality improvement activities.
... Since 2001, QCC was introduced to medical institutions in China in order to improve the quality of medical services by strengthening medical workers' awareness for discovering and solving medical problems, it is widely used in many aspects of improving medical quality. For example to reduce blood culture contamination rates for department of clinical laboratory (12), improve the intraocular lens power calculation for ophthalmology department (13), improve the hand hygiene compliance (14), reduce the incidence of catheter-associated urinary tract infection for department of nosocomial infection control (15), and so on. However, to our knowledge, no studies have been reported on QCC reducing carbapenem resistance. ...
Background:
The spread of carbapenem-resistant Gram-negative bacteria poses a substantial threat to morbidity and mortality worldwide, which is mainly attributed to the overuse of carbapenem. This study aimed to evaluate the use of a quality control circle (QCC) in controlling the overuse of carbapenems and improving the state of carbapenem resistance at a Chinese tertiary teaching hospital.
Methods:
A pharmacist-led multidisciplinary QCC project was carried out and the plan-do-check-act (PDCA) method was applied for 12 months. The data on carbapenem consumption, bacterial identification, and antibacterial susceptibility testing were collected to evaluate the effect of this project.
Results:
The antibiotics use density (AUD) of carbapenems exhibited a decreasing trend over time (P<0.001), and the AUD of meropenem, imipenem, and biapenem decreased by 30.20%, 42.45%, and 78.05% after the intervention, respectively. The total AUD of carbapenems decreased from 7.37 to 3.96, which included the decrease in the irrational use of carbapenems by 1.61, accounting for 47.21% of the total. Moreover, the positive correlations were discovered between the resistance rate of carbapenem-resistant Klebsiella pneumonia (CRKP)/Acinetobacter baumannii (CRAB) and the AUD of carbapenems (P<0.05). The resistance rate of CRKP and CRAB decreased from 51.93% and 89.21% to 32.94% and 60.66%, respectively, following QCC project implementation.
Conclusions:
This is the first study to highlight the success of a multifaceted intervention QCC project and PDCA method, which led to a significant reduction in the AUD and resistance rate of carbapenems. QCC is a feasible and effective management tool for improving the quality of carbapenem use in medical institutions.
... The PDCA (Plan-Do-Check-Act) circle or PDSA (Plan-Do-Study-Act) is also called the Deming circle because Deming created it. The PDCA circle can also be called the RUAL (Plan-Trial-Observe-Carry out) circle Chen et al. (2016). The circle describes the processes that always occur in every activity or quality performance. ...
This study is about classroom management during the Covid-19 Pandemic. This study aims to find out how the classroom should be managed during the Covid-19 Pandemic. It was done at Universitas Kristen Indonesia within three months, from February – April 2021. The method of the study is library research, where the researchers were the instruments of this study. To answer the problem of the study, the researchers collect some documents related to school management taken from online and printed journals, books, articles. The documents analyzed to provide the answers to this study were taken from the library and Google Scholar. The result of this study is that good and correct management requires commitment from all elements involved in school management, parents of students and community members who are members of the school committee, and the community in the school environment during the Covid-19 Pandemic. To run the school management smoothly, the leadership must apply the principles of transparency and professionalism. So it is concluded that those involved in the school management should cooperate, and transparency and professionalism should be implemented during the Covid-19 Pandemic.
