闭环管理模式在ICU病房多重耐药菌医院感染预防中的应用  

Application of closed-loop management mode in the prevention of nosocomial infection of multidrug-resistant organism in ICU wards

作　　者：张倩 卢瑞杰[1] 王新露 ZHANG Qian;LU Rui-jie;WANG Xin-lu

机构地区：[1]南阳市中心医院感染性疾病科ICU,南阳市473000

出　　处：《护理实践与研究》2020年第24期47-50,共4页Nursing Practice and Research

基　　金：河南省医学科技攻关计划项目2017082313。

摘　　要：目的探讨闭环管理模式在ICU病房多重耐药菌(MDROs)感染预防中的应用。方法2019年1—12月采用信息化技术手段设计闭环管理模式并对ICU病房实施管理,比较实施前(2018年1—12月)及实施后(2019年1—12月)ICU患者隔离防控措施落实率、医院感染率、MDROs发生率、医疗不良事件发生率、不良事件上报率及患者对护理流程满意率。结果实施后ICU患者隔离医嘱、床尾标识、腕带标识、手卫生、防护箱、健康宣教、床边手消毒、黄垃圾袋、仪器设备消毒、环境物品消毒等防控措施落实率高于实施前。实施后ICU医院感染率、MDROs发生率、医疗不良事件发生率低于实施前(P<0.05)。实施后ICU患者对护理服务流程、健康教育落实率、护理环境、医嘱执行满意率高于实施前。结论闭环管理模式能有效提高ICU病房隔离防控措施落实效果,降低患者医院感染率及MDROs发生率,从而提高患者对护理满意率。Objective To explore the application of closed-loop management mode in the prevention of multidrug-resistant organism(MDROs)infection in ICU wards.Methods To implement management ICU wards by using information technology to design a closed-loop management model from January to December 2019,and the implementation rate of ICU patient isolation prevention and control measures before implementation(from January to December 2018)and after implementation(from January to December 2019),nosocomial infection rate,incidence of MDROs,incidence of medical adverse event,adverse event reporting rate,and patient satisfaction rate with the nursing process were compared.Results After the implementation,the implementation rate of prevention and cont rol measures such as ICU patient isolation medical advice,bedside identification,wristband identification,hand hygiene,protective box,health education,bedside hand disinfection,yellow garbage bags,instrument and equipment disinfection,and environmental goods disinfection were higher than those before implementation.After the implementation,the nosocomial infection rate,incidence of MDROs and the incidence of medical adverse event were lower than those before the implementation(P<0.05).After the implementation,the satisfaction rate of ICU patients with the nursing service process,the implementation rate of health education,the nursing environment,and the execution of medical orders were higher than those before the implementation.Conclusion The closed-loop management model can effectively improve the implementation effect of the isolation prevention and control measures in the ICU ward,reduce the hospital infection rate of patients and the incidence of MDROs,thereby increasing the patient's satisfaction rate with care.

关 键 词：闭环管理模式 ICU病房 多重耐药菌感染 满意率 

分 类 号：R473.5[医药卫生—护理学]