综合质量改进措施在精神科医院感染控制中的效果分析  

Effect of comprehensive continuous quality improvement on nosocomial infection control in psychiatric department

作　　者：杨志彩[1] 耿喜娥[1] 李志华[2] 

机构地区：[1]山东省青州荣军医院护理部,山东青州262500 [2]潍坊医学院,山东潍坊261041

出　　处：《现代预防医学》2014年第24期4460-4462,共3页Modern Preventive Medicine

摘　　要：目的了解精神科病房实施综合质量改进措施前后的效果,为降低医院感染率提供依据。方法对2008年1月-2012年12月入住精神科>48 h的患者进行监测,将2008年1月-2009年12月设为改进前组,采用前瞻性监测与回顾性调查相结合的方式,将2010年1月-2012年12月设为改进后组,采用目标性监测方式,在改进前组感染控制措施的基础上,采取增加专业技术人员配备、改善患者住院环境、加强手卫生管理、加大培训力度及纳入专题研究等综合质量改进措施。结果质量改进措施实施前后,监测住院患者分别为441例和976例,感染率分别为11.79%和4.20%(P<0.05);漏报率由16.67%降至8.33%;抗菌药物使用率从39.23%降至23.05%(P<0.05);手卫生用品用量逐年上升。结论针对精神科医院感染的特点,开展目标性监测,落实综合质量改进措施,形成持续质量改进的良性循环,可有效预防医院感染的发生。Objective The aim of this study was to understand the effect of comprehensive continuous quality improvement in reducing the incidence rate of nosocomial infection in psychiatric department.Methods Surveillance was carried out among the patients enrolled in psychiatric department for over 48 hours between Jan 2008 and Dec 2012.Patients hospitalized from Jan 2008 to Dec 2009 were assigned as the pre-improvement group,with a prospective surveillance combined with retrospective survey.And the patients enrolled from Jan 2010 to Dec 2012 were set as the post-improvement group,with the targeted surveillance.The comprehensive continuous quality improvements such as increasing medical staff,improving the environment of the facilities and the hospital,strengthening the hand hygiene and increasing the intensity of training were performed based on the implementation of infection control.Results The number of patients was 441 in the pre-improvement group and 976 in the post-improvement group.The infection rate was 11.79% in the pre-improvement group and 4.20% in the post-improvement group（P〈0.05）.The failing report rate of hospital infection was decreased from 16.67% to 8.33%.The utilization rate of antimicrobial drugs was decreased from39.23% to 23.05%（P〈0.05）.The consumption of hand hygiene supplies was increased year by year.Conclusion In the light of the characteristics of psychiatric hospital infection,carrying out targeted surveillance and implementing the continuous quality improvement measures can effectively prevent the nosocomial infections so as to formulate a virtuous cycle of continuous quality improvement.

关 键 词：精神科 医院感染 质量改进措施 效果分析 

分 类 号：R19[医药卫生—卫生事业管理] R749[医药卫生—公共卫生与预防医学]