集束干预策略在预防ICU多药耐药菌感染的应用研究  

Study on the application of cluster intervention strategies for prevention of multi-drug resistant infections in ICU

作　　者：邬莹玉 刘立志 包红亚 陈国栋 丁汀[3] 

机构地区：[1]奉化市人民医院ICU,浙江奉化315500 [2]奉化市人民医院心内科,浙江奉化315500 [3]杭州市第二人民医院血液内科,浙江杭州310024

出　　处：《中华医院感染学杂志》2014年第24期6114-6116,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅科技基金资助项目(2013KYB212)

摘　　要：目的探讨集束干预策略在ICU多药耐药菌感染预防中的效果,为临床治疗提供参考依据。方法医院2011-2012年选取ICU治疗中进行常规护理的患者289例作为对照组,并于2012-2013年选取327例ICU患者为试验组进行集束化护理,对比两组治疗结局、患者的感染率、感染发生时间、治疗费用,采用SPSS 13.0进行统计分析。结果对照组出现多药耐药菌感染65例占22.49%,试验组出现多药耐药菌感染48例占14.68%,经过集束干预策略后,感染率明显降低,对比差异有统计学意义(P<0.05);对照组住院时间达(19.03±3.22)d、试验组为(11.10±2.89)d,两组对比差异有统计学意义(P<0.05);重症病房医务人员手卫生考试合格率为100.00%,手卫生依从率≥90.00%,无菌化手术衣穿着率为100.00%,穿刺当天导管维护率100.00%,无菌敷料吸收渗液的24h内更换率为100.00%。结论集束干预策略对ICU多药耐药菌感染的预防效果显著确切,值得临床推广应用。OBJECTIVE To investigate the effect of cluster intervention strategies for prevention of multi‐drug resistant infections in ICU so as to provide reference for clinical treatment .METHODS Totally 289 ICU patients receiving conventional nursing during 2011 - 2012 were enrolled as the control group and 327 ICU patients during 2012-2013 receiving cluster interventions as the experimental group .The two groups were compared for treat‐ment outcomes ,infection rate ,occurrence time of infection ,and cost of treatment .The software SPSS 13 .0 was used for statistical analysis .RESULTS The control group had 65 cases of multi‐drug resistant infections ,account‐ing for 22 .49% ,while the experimental group had 48 cases ,accounting for 14 .68% .After the cluster interven‐tion ,the infection rate was significantly lower in the experimental group （P＆lt;0 .05） .The hospitalization time was （19 .03 ＆#177; 3 .22） d in the control group and （11 .10 ＆#177; 2 .89） d in the experimental group ,the difference was signifi‐cant （P＆lt;0 .05） .The pass rate of hand hygiene examination for medical staff in ICU was 100 .00% ,the compli‐ance rate of hand hygiene ≥90 .00% ,the rate for sterile surgical wearing 100 .00% ,the daily maintenance rate of puncture catheter 100 .00% ,the replacement rate of sterile dressing for absorbing exudates in 24 hours 100 .00% . CONCLUSION Cluster intervention strategies showed a significant preventive effect for multi‐drug resistant infec‐tions in ICU ,which is worthy of clinical application .

关 键 词：集束干预策略 重症监护病房 多药耐药菌 感染 预防 

分 类 号：R181.31[医药卫生—流行病学]