提高多重耐药菌防控措施执行力对降低多重耐药菌医院感染的影响  

Effect of improving compliance to multidrug-resistant organism prevention and control measures on reducing MDRO healthcare-associated infection

作　　者：李颖[1] 许文[1] 戈伟[1] 慕彩妮[1] 曹小琴[1] 范珊红[1] 

机构地区：[1]第四军医大学唐都医院,陕西西安710038

出　　处：《中国感染控制杂志》2017年第2期126-129,共4页Chinese Journal of Infection Control

基　　金：陕西省科学技术研究发展计划项目(2012K18-01-05);第四军医大学唐都医院科技创新发展基金临床研究项目(2014LCYJ006)

摘　　要：目的了解提高多重耐药菌(MDRO)预防控制措施依从率对重症监护病房(ICU)MDRO传播的影响。方法选择2014年3—6月某院5个ICU的所有患者,2014年3月1日—4月30日为基线调查阶段,2014年5月1日—6月30日为干预阶段(采取综合干预措施),比较干预前后5个ICU MDRO患者接触隔离措施落实情况、医护人员MDRO相关知识知晓情况。结果干预后医务人员对MDRO传播方式、接触隔离措施和转科告知知晓率(分别为100.00%、98.89%、93.33%),均高于干预前(分别为67.22%、61.11%、45.56%);除单间隔离外,其他防控措施(隔离医嘱、床旁隔离、穿隔离衣、挂隔离标志)的依从率(>70%)均高于干预前(<50%)(均P<0.01)。干预后MDRO的检出率为7.16%(90/1 257),低于干预前9.65%(117/1 212)(χ~2=5.00,P=0.03)。结论采取综合干预措施,可以提高医务人员MDRO防控措施的执行力度,减少MDRO的传播。ObjectiveTo understand the effect of improving compliance rate to multidrugresistant organism （MDRO） prevention and control measures on reducing MDRO transmission in the intensive care unit （ICU）. MethodsAll patients in 5 ICUs of a hospital in MarchJune 2014 were chosen, March 1April 30, 2014 was baseline survey stage, May 1June 30, 2014 was intervention stage （comprehensive intervention measures were taken）, the implementation of patients contact isolation measures, as well as awareness of MDROrelated knowledge among health care workers（HCWs） in 5 ICUs before and after intervention were compared respectively. ResultsHCWs’ awareness rates of MDRO transmission modes, contact isolation measures, and informing of department transfer after intervention were all higher than before intervention（100.00% vs 67.22%, 98.89% vs 61.11%, 93.33% vs 45.56%, respectively）; except singleroom isolation,compliance rates to other prevention and control measures（including doctor’s advice on isolation, bedside isolation, wearing isolation gowns, adding isolation logo） were all higher than before intervention（〉70% vs 〈50%, all P〈0.01）. Detection rate of MDROs after intervention was lower than before intervention （7.16%[90/1 257] vs 9.65%[117/1 212], χ^2=5.00,P=0.03）. ConclusionComprehensive intervention measures can improve HCWs’ compliance to prevention and control measures on MDROs, and reduce the transmission of MDROs.

关 键 词：多重耐药菌 预防控制 干预措施 执行力 

分 类 号：R181.32[医药卫生—流行病学]