医疗机构门诊医护人员呼吸道感染风险量化评估方法与实践  

Quantitative risk assessment on respiratory tract infection of health care workers in outpatient settings

作　　者：王允琮 王力红[1] 赵霞[1] 张京利[1] 马文晖[1] 赵会杰[1] 韩叙[1] WANG Yun-cong;WANG Li hong;ZHAO Xia;ZHANG Jing-li;MA Wen-hui;ZHAO Hui-jie;HAN Xu(Xuan Wu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院医院感染管理处,北京100053

出　　处：《中华医院感染学杂志》2020年第22期3493-3497,共5页Chinese Journal of Nosocomiology

基　　金：北京市属医院科研培育计划基金资助项目(PG2019018)。

摘　　要：目的设计一套适用于医疗机构门诊医护人员呼吸道感染风险的量化评估体系,并用于风险评估的实践。方法以首都医科大学宣武医院门诊各科室为研究对象,首先利用头脑风暴法、文献荟萃法和专家咨询法识别门诊医护人员呼吸道感染风险点,形成风险评估体系的基本框架,之后利用层次分析法计算各风险点权重,设计量化评分指标用于评估实践。最后根据评估结果利用加权秩和比法划分门诊科室风险等级。结果共识别出风险点18项,分为"诊疗过程"、"环境和布局"、"人员防护"和"应急处置"四大类。其中权重最大的风险点为"诊疗过程中包含呼吸道近距离(或喷溅)操作"。量化评分指标含单项选择4个、多项选择2个、比值指标12个。实践结果显示,25个门诊科室可分为高风险等级5个,中风险等级9个,低风险等级11个,其中高风险科室为:急诊科、儿科、口腔科、耳鼻喉-头颈外科和呼吸与危重症医学科。结论本研究构建了一套适用于医疗机构门诊医护人员呼吸道感染风险的量化评估体系,实践结果可用于针对性风险管理。OBJECTIVE To design a semi-quantitative risk assessment model for respiratory infection of health care workers(HCWs) in outpatient settings and to apply it in risk assessment practice. METHODS The outpatient settings of XuanWu Hospital Capital Medical University were selected as the study objects. Brainstorm, literature extraction and expert consultation process were employed to recognize risk points so as to build the framework of the model, then the Analytic Hierarchy Process(AHP) was used to calculate the weight of risk points to finish the construction of risk assessment model, the indicators for each risk point were designed for assessment practice, finally the risk level of outpatient clinics was assessed by weighted rank sum ratio method. RESULTS Totally 18 risk points were recognized, including’diagnosis and treatment process’ ’environment and layout’,’personal protection"and’emergency handling’.The risk point with the largest weight was’ close respiratory tract examination(with aerosol generation possibility’.The associated indicators included 4 single selections, 2 multiple selections and 12 ratio numerals. The practice result showed that 25 outpatient clinics could be divided into 5 high risk levels, 9 medium risk levels and 11 low risk levels. The clinic of emergency, clinic of pediatrics, clinic of stomatology, clinic of otolaryngology and clinic of respiratory and critical care medicine were in the high risk level. CONCLUSION A quantitative risk assessment model was established in the study, which can be used in risk assessment practice and provide targeted management suggestions.

关 键 词：呼吸道感染 风险量化评分 风险等级 

分 类 号：R197.3[医药卫生—卫生事业管理]