摘要
目的基于KANO模型优化分娩机构新生儿免疫规划管理系统服务,分析应用效果。方法运用Delphi法设计KANO模型的分娩机构新生儿免疫规划管理系统服务需求调查问卷,于2017年5月对643名新生儿家长进行调查,根据结果进行服务需求分析,实施多部门协作优先建设或优化预防接种、免疫规划方案个性化管理、接种及时性管理、安全注射管理和防疫站-医院-社区一体化管理等措施。实施前后分别调查300名家长和300名新生儿。观察实施前后24 h乙肝疫苗接种及时率、特殊情况新生儿首次预防接种时间、特殊情况下出院前乙肝疫苗接种率、疑似疫苗反应发生率、卡介苗耗损系数、家长满意度。结果 KANO模型下新生儿免疫规划管理系统服务需求内容属性分类中期望质量17项,魅力质量3项,分别为一体化管理、提供个性化预防接种方案和特殊情况的导医服务。重要度和满意度排名最高的分别是接种及时(97.18%)和安全注射(89.26%)。实施后与实施前比较,24 h内乙肝疫苗接种率由90.66%提高到95.33%;特殊新生儿首次预防接种的时间由(9.90±2.23)d减少至(3.30±1.49)d,而出院前乙肝疫苗接种率由75.00%提高到96.43%;卡介苗损耗系数由4.40降低到1.70,疑似疫苗反应发生率由18.33‰降到5.00‰;家长满意度由81.00%提高到93.00%;以上差异均有统计学意义(P<0.05)。结论以KANO模型为导向的新生儿免疫规划管理系统优化,确保了疫苗接种的及时性,形成了一体化的服务模式,提高了家长的信任度,提升了医院的竞争力。
Objective To optimize the neonatal immunization management system based on the KANO model,and to evaluate its practical use. Methods A KANO model based questionnaire about health needs on neonatal immunization management system w as designed by using Delphi method,and a questionnaire survey w as conducted to 643 parents w hoes new borns w ere born in institutions for childbirth. The health needs of parents on neonatal immunization system management w ere analyzed based on results of KANO model. Improvement measures w ere carried out including multi-department collaboration on developing standards and contraindications for vaccination,individualized management of immunization planning scheme,timely administration of vaccination,safe injection management,and epidemic-prevention station-hospital-community integrated management. The related indexes such as vaccination rate of hepatitis B vaccine w ithin 24 hours after birth,first time of vaccination,vaccination rate of hepatitis B vaccine before discharge,incidence of vaccine suspected-adverse reactions,coefficient in loss of bacillus CalmetteGuerin vaccine and satisfactory degree of parents w ere assessed before and after implementation of modified neonatal immunization management system. Results There w ere 17 items of expected quality and 3 items of attractive quality（ integrated management,individualized vaccination plan and immunization service under special conditions） generated by using KANO model. The timely vaccination w as the most key quality attributes in importance（ 97. 18%）,and the safe injection w as the most key quality attributes in satisfaction（ 89. 26%）. The vaccination rate of hepatitis B vaccine w ithin 24 hours after birth w as increased from 90. 66% before implementation of management system to 95. 33% after implementation of management system. The first time of vaccination among new borns w ith special conditions decreased form（ 9. 90 ± 2. 23） days to（ 3. 30 ± 1. 49）days,and vaccination rate of hepatitis B vaccine before
作者
刘颖
高圆梦
陈冰秋
石静楠
张格
赵芳
LIU Ying;GAO Yuanmeng;CHEN Bingqiu;SHI Jingnan;ZHANG Ge;ZHAO Fang(Department of Obstetrics,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan,453100;School of Biomedical Engineering,Xinxiang Medical University,Xinxiang,Henan,453103)
出处
《中西医结合护理（中英文）》
2018年第7期35-40,共6页
Journal of Clinical Nursing in Practice
关键词
免疫规划
KANO模型
服务需求
信息化
一体化管理
安全注射
immunization planning
KANO model
service demand
informatization
integrated management
safe injection
