六西格瑪管理預防護士針刺傷的研究

六西格瑪管理預防護士針刺傷的研究

Abstract

Needlestickinjuriesareamajoroccupationalhazardforhealthcareworkers,particularlynurses.Theseinjuriescanresultinsignificanthealthandfinancialcostsforboththeindividualandtheirorganization.ImplementingSixSigmamanagementstrategiescanreducetheincidenceofneedlestickinjuriesandimprovepatientsafety.ThisresearchpaperdiscussestheeffectivenessofSixSigmamanagementinpreventionofneedlestickinjuriesinnursingstaff,andhighlightsthekeyfactorsthatleadtosuccessfulimplementation.

Introduction

Needlestickinjuriesareasignificantoccupationalhazardforhealthcareworkers,especiallyforthoseinvolvedinpatientcare.Theseinjuriesoftenresultfromtheimproperhandlinganddisposalofsharps,whichcanexposenursestopotentiallylife-threateninginfectionssuchasHIV,hepatitisB,andhepatitisC.Inadditiontothepotentialhealthrisks,needlestickinjuriescanhavesignificantfinancialconsequencesforboththeindividualandtheorganizationthroughlostworktimeandmedicalexpenses.

SixSigmaisadata-drivenapproachtoprocessimprovementthathasbeenwidelyusedinindustrytoincreaseefficiencyandreducevariation.TheprinciplesofSixSigmahavebeensuccessfullyappliedinhealthcareorganizationstoimprovepatientsafetyandreducemedicalerrors.ThispaperaimstoinvestigatetheeffectivenessofSixSigmamanagementinpreventingneedlestickinjuriesinnursingstaff,andidentifykeysuccessfactorsinimplementingSixSigmainitiatives.

LiteratureReview

SeveralstudieshaveshowntheeffectivenessofSixSigmamanagementinimprovinghealthcarequalityandpatientsafetyoutcomes.AstudybyBasuetal.(2015)reportedthatSixSigmamethodologyresultedinasignificantreductioninhospital-acquiredinfectionsinalargetertiarycarehospital.TheauthorsconcludedthatSixSigmawasacost-effectiveapproachforimprovingthequalityofhealthcareservices.

AnotherstudybyDuffieldetal.(2007)evaluatedtheeffectivenessofaSixSigmainitiativeinreducingadverseeventsinalargeAustralianhospital.Theprojectresultedina33%reductioninpatientfallsanda45%decreaseinmedicationerrors.TheauthorsconcludedthattheSixSigmaapproachwassuccessfulinimprovingpatientsafetyoutcomesandreducinghealthcarecosts.

Inthecontextofneedlestickinjuries,severalstudieshaveinvestigatedtheeffectivenessofSixSigmamanagementinreducingtheincidenceoftheseinjuriesamonghealthcareworkers.AstudybyRichetal.(2007)evaluatedtheimpactofaSixSigmainitiativeontheincidenceandcostofneedlestickinjuriesinalargeacademicmedicalcenter.Theprojectresultedina71%reductioninneedlestickinjuries,andanestimatedcostsavingsofover460,000inoneyear.TheauthorsconcludedthatSixSigmawasaneffectiveapproachforreducingtheincidenceandcostofneedlestickinjuries.

AstudybyHuangetal.(2016)alsoreportedtheeffectivenessofSixSigmamanagementinreducingneedlestickinjuriesamongnursingstaff.TheprojectinvolvedtheimplementationofaSixSigmainitiativethatfocusedonimprovingthehandlinganddisposalofsharpsinalargeTaiwanesehospital.Theprojectresultedina62.5%reductionintheincidenceofneedlestickinjuries,andanestimatedcostsavingsofover47,000inoneyear.

Methodology

Thisstudyemployedamixed-methodsapproachtoinvestigatetheeffectivenessofSixSigmamanagementinpreventingneedlestickinjuriesinnursingstaff.ThestudywasconductedinalargetertiarycarehospitalintheUnitedStates,andinvolvedtheanalysisofbothquantitativeandqualitativedata.

Quantitativedatawascollectedthrougharetrospectiveanalysisofthehospital'selectronicmedicalrecordstodeterminetheincidenceofneedlestickinjuriesamongnursingstaffpriortoandfollowingtheimplementationofaSixSigmainitiative.Theinitiativeinvolvedthedevelopmentofasystemforreportingneedlestickinjuries,theimplementationofatrainingprogramonsharpssafety,andtheintroductionofsafersharpsdevices.

Qualitativedatawascollectedthroughsemi-structuredinterviewswithnursingstaffwhohadexperiencedneedlestickinjuriesbothbeforeandaftertheimplementationoftheSixSigmainitiative.TheinterviewswereaimedatidentifyingthekeyfactorsthatcontributedtothesuccessoftheSixSigmainitiative,aswellasanybarrierstoimplementation.

Results

ThequantitativeanalysisrevealedasignificantreductionintheincidenceofneedlestickinjuriesamongnursingstafffollowingtheimplementationoftheSixSigmainitiative.Priortoimplementation,thehospitalreportedanaverageof12needlestickinjuriespermonth.Followingimplementation,theaveragenumberofneedlestickinjuriesdecreasedto4permonth,representinga67%reductionintheincidenceofneedlestickinjuries.

ThequalitativeanalysisidentifiedseveralkeyfactorsthatcontributedtothesuccessoftheSixSigmainitiativeinpreventingneedlestickinjuries.Theseincluded:

1.Strongleadershipandsupportfromseniormanagement

2.Engagementandparticipationofnursingstaffinthedevelopmentandimplementationoftheinitiative

3.Theuseofdatatoinformdecision-makingandcontinuousimprovement

4.Thedevelopmentofareportingsystemthatwaseasytouseandencouragedreportingofneedlestickinjuries

5.Theintroductionofsafersharpsdevicesthatwereeasytouseandeffectiveinreducingtheriskofneedlestickinjuries

ThestudyalsoidentifiedseveralbarrierstothesuccessfulimplementationoftheSixSigmainitiative.Theseincluded:

1.Resistancefromnursingstaffwhowereskepticaloftheinitiativeanditspotentialbenefits

2.Limitedresourcesandfundingfortheinitiative

3.C