以 KANO 模型为导向的新生儿免疫规划管理系统服务优化

[摘要] Abstract：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 was designed by using Delphi method, and a questionnaire survey was conducted to 643 parents whoes newborns were born in institutions for childbirth. The health needs of parents on neonatal immunization system management were analyzed based on results of KANO model. Improvement measures were 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 within 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 Calmette-Guerin vaccine and satisfactory degree of parents were assessed before and after implementation of modified neonatal immunization management system. Results 〓There were 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 was the most key quality attributes in importance(97.18%), and the safe injection was the most key quality attributes in satisfaction(89.26%). The vaccination rate of hepatitis B vaccine within 24 hours after birth was increased from 90.66% before implementation of management system to 95.33% after implementation of management system. The first time of vaccination among newborns with special conditions decreased form(9.90±2.23)days to(3.30±1.49)days, and vaccination rate of hepatitis B vaccine before discharge increased from 75.00% to 96.43%, with a significant difference(P<0.05). There was an decreased coefficient in loss of bacillus Calmette-Guerin vaccine(4.40 vs. 1.70, P<0.05)and decreased incidence of vaccine suspected-adverse reactions(18.33‰ vs. 5.00 ‰, P<0.05). The satisfactory rate of parents on vaccination service was improved from 81.00% to 93.00 %(P<0.05). Conclusion 〓The neonatal immunization management system based on the KANO model is effective to ensure the timeliness of vaccination and community participation. It helps to form a people-oriented integrated service model, improve parents' trust in health service, and effectively promote the competitive advantage of the hospital.

[学科分类] 护理学

[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