医院综合ICU环境表面清洁效果持续质量改进的研究与分析  

Study and analysis of continuous quality improvement on environmental surface cleaning in hospital general ICU

作　　者：姚静[1] 邢虎[1] 赵燕燕[1] 吴洪敏[1] 高燕[1] 胡振奎[1] YAO Jing;XING Hu;ZHAO Yan-yan;WU Hong-min;GAO Yan;HU Zhen-kui(Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院

出　　处：《中国消毒学杂志》2019年第7期509-512,共4页Chinese Journal of Disinfection

摘　　要：目的研究持续质量改进措施对综合ICU环境表面清洁效果的改善情况。方法设定2016年10月-2016年12月为持续质量改进前,2017年1月-2017年9月为持续质量改进阶段。制定质量改进措施并实施,对综合ICU环境表面进行采样并鉴定细菌菌种。按季度统计综合ICU住院患者医院感染率、下呼吸道感染率、泌尿道感染率和血流相关感染率。结果持续质量改进前环境表面采样合格率为58. 49%,持续质量改进阶段环境表面采样合格率为76. 92%,两组数据比较差异有统计学意义(χ2=19. 36,P <0. 01)。环境表面细菌菌种鉴定主要为金黄色葡萄球菌、鲍曼不动杆菌和白假丝酵母菌。经持续质量改进后,检出菌菌株数均显著下降。综合ICU住院患者医院感染率、下呼吸道感染率、泌尿道感染率和血流相关感染率在持续质量改进阶段也呈下降趋势。结论持续质量改进措施可以有效提高综合ICU环境清洁效果,减少环境表面致病菌,降低住院患者医院感染率。Objective To study and analyze the influence of continuous quality improvement on environmental surface cleaning in general ICU. Methods Oct 2016 to Dec2016 was set as the pre-stage of continuous quality improvement,and Jan 2017 to Sep 2017 was the stage of continuous quality improvement. The continuous quality improvement program was formulated and implemented,bacterial colonies were identified after sampling the environmental surface of the general ICU.The nosocomial infection rate,lower respiratory tract infection rate,urinary tract infection rate and blood flow related infection rate of inpatients in integrated ICU were calculated quarterly. Results The qualified rate of environmental surface sampling was 58. 49% at the pre-stage of continuous quality improvement and 76. 92% at the stage of continuous quality improvement. The difference between the two groups was statistically significant(χ2= 19. 36,P 0. 01). The identification of bacterial strains on the surface of the environment was mainly Staphylococcus aureus,Acinetobacter baumanii and Candida albicans. After continuous quality improvement,the number of bacterial strains detected decreased significantly. The nosocomial infection rate,lower respiratory tract infection rate,urinary tract infection rate and blood flow related infection rate were also decreasing in the continuous quality improvement stage of ICU inpatients. Conclusion Continuous quality improvement measures can effectively improve the environmental cleaning effect of general ICU,decrease environmental surface pathogens,and reduce the nosocomial infection rate of inpatients.

关 键 词：环境表面 持续质量改进 清洁效果 

分 类 号：R187.2[医药卫生—流行病学]