ICU质量核查对医院感染的影响  

Effect of ICU daily quality checklist on nosocomial infection

作　　者：赵旭明[1] 朱建军[1] 张明霞[2] 刘励军[1] 

机构地区：[1]苏州大学附属第二医院ICU,江苏苏州215004 [2]苏州大学附属第二医院感染管理科,江苏苏州215004

出　　处：《中华医院感染学杂志》2013年第23期5762-5764,共3页Chinese Journal of Nosocomiology

基　　金：苏州市卫生局科教兴卫青年科技基金项目(KJXW2011017)

摘　　要：目的探讨使用ICU每日质量核查单强化医疗质量管理,对ICU患者医院感染的影响,为预防ICU医院感染提供依据。方法将综合ICU患者分为两组,使用每日质量核查单的2012年1-11月患者591例作为干预组,未使用检查单的2011年1-11月患者553例作为对照组,比较两组患者医院感染及预后的变化。结果干预前后两组间性别、年龄及APACHEII评分等资料比较,差异无统计学意义;两组间导管相关血流感染、导尿管相关感染发生率及每千导管日感染率比较,差异无统计学意义;而对照组呼吸机相关性肺炎的感染率及每千导管日感染率由15.55%、24.14‰降至干预后的9.98%、16.35‰(χ2=8.00、98.13,P<0.05);虽然两组间28d病死率差异无统计学意义,但ICU住院时间由干预前平均15.6d降至干预后平均12.2d(P<0.05)。结论通过实行每日质量核查,可有效减少综合ICU患者呼吸机相关性肺炎的发生率,同时减少ICU住院时间。OBJECTIVE To explore the effect of ICU daily quality checklist on nosocomial infection by enhancing medical quality management, and provide basis for the prevention of nosocomial infection in ICU. METHODS The patients of general ICU were divided into two groups. The patients using the daily quality checklist of ICU from Jan. to Nov. 2012 composed the intervention group （n=591）, and the control group consisted of the patients with no quality checklist from Jan. to Nov. 2011 （n=553）. The changes in the nosocomial infection and patient outcomes of two groups were compared. RESULTS The differences of gender, age and APACHE Ⅱ scores of the patients in the two groups were not significant. The incidence of catheter related bloodstream infection and cathe-ter-associated urinary tract infection were compared between the two groups and the difference was not statistically significant. However, the rate of ventilator associated pneumonia （VAP） decreased from 15. 55% and 24. 14%0 （per 1, 000 ventilator days） in control group to 9.98% and 16.35‰ in intervention group （X^2 = 8.00, 98.13, P〈0.05）. Although no significant difference in 28-days mortality were found, ICU length of stay decreased from a mean of 15.6 days to 12.2 days （P〈0.05） after implementation of the quality checklist. CONCLUSION Through the implementation of the daily quality checklist, the incidence of VAP and ICU length of stay canbe effectively reduced.

关 键 词：呼吸机相关性肺炎 导管相关性血流感染 导尿管相关性感染 

分 类 号：R197.323[医药卫生—卫生事业管理]