摘要目的:调查某医院临床医师外科换药操作规范执行情况及影响其规范执行的相关因素，并制定相应对策，提升临床医师换药操作规范化。方法:2016年2至9月综合运用品管圈管理方法，通过主题选定、计划拟定、现况把握、目标设定、原因解析、对策拟定、对策实施、效果确认、标准化等步骤，实施品管圈活动，按照PDCA循环进行持续质量改进，比较评价活动效果。本研究应用自身对照研究，通过成立品管圈活动小组"携手圈"，运用品质管理工具，使用自拟的"换药操作实践技能考核表"和"换药操作不规范原因调查表"，对77名临床医师进行问卷调查和观察，比较品管圈活动干预前后提高临床医师换药操作规范合格率的情况。采用SPSS 20.0进行 t检验和 χ2检验。 结果:品管圈活动干预后,临床医师换药操作规范相关质量指标均明显升高。活动前均分（80.45±9.42），活动后均分（90.06±3.43）（ P<0.01）。临床医师换药操作规范合格率由活动前的57.14%提升至活动后的98.70%（ P<0.01），达到了设定的90.98%目标值。操作关键项目中的衣着规范率、手卫生措施执行率、消毒隔离措施合格率、无菌操作合格率、物品处理合格率与品管圈活动实施前相比，差异均具有统计学意义。品管圈活动后医师各项能力也均有不同程度提升。 结论:通过开展品管圈活动进行持续质量改进，能取得良好效果。品管圈质量管理方法可以有效地解决感染管理工作中的问题，是感染管理工作规范化、标准化、科学化的有效工具。

abstractsObjective:To investigate the implementation of surgical dressing change standard and related factors influencing the implementation in a hospital, and to formulate the corresponding countermeasure for improving the dressing change standardization of clinicians.Methods:From February to September, 2018, the quality control circle (QCC) was comprehensively exerted and QCC activities were implemented through selecting topic, making plans, controlling current status, setting goals, analyzing causes, proposing and practicing countermeasures, confirming effects and standardizing the process. The quality was continuously improved on the basis of the PDCA cycle and effects were evaluated. In this study, self-control study was used; QCC activity team of "hand-in-hand circle" was set up; quality management tools were used; self-designed assessment table of dressing change skills and questionnaire for nonstandard reasons of dressing change were used to conduct the questionnaire survey and observation for 77 clinicians, and improvement of standard rate before and after the QCC intervention was compared. SPSS 20.0 was used to perform the t-test and χ2 test. Results:After QCC activity, relative quality indexes of dressing change were significantly increased. The pre-activity average score was (80.45±9.42) and the post-activity average score was (90.06±3.43) ( P<0.01). The standard rate of dressing change of the clinical physician was increased from pre-activity 57.14% to post-activity 98.70% ( P<0.01), which reached the target value of 90.98%. After QCC activity, dress standard rate, enforced rate of hand hygiene measures, qualification rates of disinfection isolation measures, aseptic operation and disposed items were improved significantly. In addition, the ability of circle members also improved differently. Conclusion:QCC activities can continuously improve the quality, obtaining good results. Quality management of QCC can effectively solve problems in infection management, which is an effective tool in the standardization, normalization and scientization of infection management.