综合目标评估对ICU医院感染预防控制效果分析  

Effect of comprehensive medical goal appraisal on prevention and control of healthcare-associated infections in ICU

作　　者：贾会学[1] 任军红[1] 贾建侠[1] 赵艳春[1] 赵秀莉[1] 姚希[1] 殷环[1] 李六亿[1] 

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中华医院感染学杂志》2016年第11期2611-2613,共3页Chinese Journal of Nosocomiology

基　　金：国家卫计委医院感染预防与控制能力建设基金资助项目(CHA-2012-XSPX-0629-1)

摘　　要：目的了解综合目标评估对降低ICU医院感染率的预防控制效果,以降低医院感染率。方法 2013年开始采取医疗综合目标评估,如签署目标责任书、每月进行医院感染管理工作评价,评价结果现场反馈并记录,持续关注改进等,比较干预前后ICU医院感染率;采用Stata9.0软件进行统计分析。结果干预后ICU总体医院感染率及多药耐药菌例次感染率分别为5.15例次/千住院日和1.67例次/千住院日,均较干预前明显下降,差异有统计学意义（RR=0.75,95%CI：0.63-0.90,P〈0.01;RR=0.54,95%CI：0.41-0.73,P〈0.01）;干预后ICU总体感染管理评分较干预前明显升高,由94.1分上升至97.4分;各项工作中手卫生提升最为明显,ICU总体手卫生依从性由59.22%上升至90.01%,2013-2015年较2012年明显升高,差异有统计学意义（χ^2=212.33,P〈0.01）。结论综合目标评估管理措施有效推进了各项医院感染预防控制措施,并降低了ICU医院感染率。OBJECTIVE To investigate the effect of comprehensive medical goal appraisal on prevention and control of healthcare-associated infections in ICU so as to reduce the incidence of healthcare-associated infections.METHODS The comprehensive medical goal appraisal was adopted since 2013,including signing target responsibility documents,monthly assessment of control of healthcare-associated infections,onsite feedback and record,and continuous concern and improvement;the incidence of healthcare-associated infections in the ICU was compared before and after the interventions were taken,and the statistical analysis was performed with the use of Stata9.0software.RESULTS The overall incidence of healthcare-associated infections was 5.15case-times/1000 hospitalization days in the ICU after the intervention,the case-time rate of multidrug-resistant organisms infections was 1.67case-times/1000 hospitalization days in the ICU after the intervention,and there was significant difference before and after the intervention（RR=0.75,95%CI：0.63-0.90,P〈0.01;RR=0.54,95%CI：0.41-0.73,P〈0.01）.The overall score of infection control was remarkably increased from 94.1points to 97.4points in the ICU after the intervention.The hand hygiene was improved most significantly,the overall hand hygiene compliance was increased from 59.22% to 90.01% in the ICU,and it was increased more significantly during 2013-2015 than in2012,with statistical significance（χ^2=212.33,P〈0.01）.CONCLUSIONThe comprehensive medical goal appraisal can effectively promote the implementation of prevention measures and reduce the incidence of healthcare-associated infections.

关 键 词：综合目标评估 重症监护病房 医院感染 效果 

分 类 号：R181.3[医药卫生—流行病学]