建立医院感染风险评估机制预防控制医院感染  

Establishment of risk assessment mechanism of nosocomial infections in prevention and control of nosocomial infections

作　　者：董卫国[1] 陈静[1] 史登平 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060 [2]荆门市第二人民医院消化内科,湖北荆门448000

出　　处：《中华医院感染学杂志》2015年第12期2865-2867,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金项目(2013CFC064)

摘　　要：目的探讨建立住院患者医院感染风险评估机制,分类落实预防控制医院感染措施,降低医院感染率。方法选取医院2010年5月-2013年5月发生医院感染793例为试验组,随机抽取未发生医院感染的1 000例为对照组,分别对两组患者的年龄、病情、住院天数、侵入性操作、抗菌药物使用等危险因素进行统计分析,构建logistic回归模型,估计参数,标准化各影响因素系数,计算出分值及风险级别。结果根据统计变量结果并结合医院感染管理日常监测指标,遴选出疾病诊断、基础疾病、导管植入、呼吸机使用、手术类型及时间、麻醉类型、有无植入物、放化疗、糖皮质激素使用、抗菌药物使用、住院时间等13个影响因素作为评估指标;通过构建logistic回归模型,评价模型效果:灵敏度83.6%,特异度76.2%;计算出各评估指标分值,≥5分为高危人群;建立医院感染风险评估表。结论建立住院患者医院感染风险评估表,通过对住院患者的有效评估,分类预防控制医院感染,对高危患者提前干预预防控制,可预期达到降低医院感染率。OBJECTIVE To explore the risk assessment mechanism of nosocomial infections in hospitalized patients and implement the prevention and control measures so as to reduce the incidence of nosocomial infections . METHODS A total of 793 patients with nosocomial infections who were hospitalized from May 2010 to May 2013 were chosen as the experimental group ,while 1 000 patients without nosocomial infections were randomly selected as the control group .The risk factors including the age ,illness condition ,length of hospital stay ,invasive opera‐tion ,and use of antibiotics were statistically analyzed ,the logistic regression model was established ,the parame‐ters were estimated ,the coefficients of the influencing factors were standardized ,and the value and risk levels were calculated .RESULTS According to the results of statistical analysis of variables combined with daily surveil‐lance indicators ,totally 13 influencing factors were screened out as the assessment indicators ,including the diag‐nosis of diseases ,underlying diseases ,catheterization ,use of ventilator ,types of surgery ,operation duration , types of anesthesia ,implants ,radiochemotherapy ,use of glucocorticoids ,use of antibiotics ,and length of hospital stay .The results of the logistic regression analysis showed that the sensitivity was 83 .6% and the specificity was 76 .2% ,the patients with the indicator assessment score no less than 5 points were the population at high risk of nosocomial infections ,and the risk assessment table for nosocomial infections has been established .CONCLUSION It is an effective way to establish the risk assessment table for nosocomial infections in the hospitalized patients , conduct classified prevention and control of nosocomial infections ,and take interventions to the high risk patients in advance so as to reduce the incidence of nosocomial infections .

关 键 词：医院感染 风险评估 控制 研究 

分 类 号：R197.323[医药卫生—卫生事业管理]