贵州省47所医疗机构医院感染风险调查与评估  

Investigation and assessment of management associated with hospital infection risks in 47 medical institutions in Guizhou province

作　　者：徐艳[1] 杨怀[1] 牟霞[1] 张曼[1] 贺玲[1] 杨廷秀[1] 任钰 刘玮[1] 陈黎媛 薛婷[1] 王振宇[1] XU Yan;YANG Huai;MOU Xia;ZHANG Man;HE Ling;YANG Ting-xiu;REN Yu;LIU Wei;CHEN Li-yuan;XUE Ting;WANG Zhen-yu(Guizhou Provincial Hospital,Guiyang,Guizhou 550002,China)

机构地区：[1]贵州省人民医院医院感染管理科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2020年第24期3812-3816,共5页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅基金资助项目(黔科合基础[2016]1509)。

摘　　要：目的为了解贵州省医疗机构医院感染管理工作现状,明确风险级别及高危环节,强化管理的针对性,实现精准化感染控制,降低医院感染暴发风险。方法2017年2月-6月,贵州省医院感染管理培训基地全省招募医疗机构开展医院感染风险管理研究,统一培训,按照研究方案逐步实施,分别进行基线调研、医院层面评估、科室层面评估、对高风险环节进行为期三个月干预并进行效果评价。结果贵州省47所医疗机构开展了医院层面及科室层面风险评估,其中18所医疗机构风险识别项目达到同质化,临床部门风险评估分值频数分布呈非正态分布,75.3%的临床部门感染风险处于中或中低水平,风险因素最高为神经外科ICU,分值为156.0,风险最高的前十位中包括了4所医院的ICU、4所医院的神经外科及2所医院的神经外科ICU;32所医疗机构开展极高风险科室高风险环节干预,干预前组观察病例数8119例,干预后组观察病例数9279例,比较干预前组及干预后组,医院感染发生率从3.806%降至1.908%,医院感染例次发病率由4.175%降至1.972%,差异均有统计学意义(P<0.001)。结论贵州省医疗机构推行医院感染风险管理模式,从医院层面及科室层面分层次评估,明确了重点部门及重点环节,针对性干预,实现精准化感控,有效降低医院感染发病率,对贵州省医院感染防控工作有着较大的推动作用。OBJECTIVE To investigate the current status of hospital associated infection(HAI)management in medical institutions in Guizhou province,to identify the risk factors and steps,in order to apply the precise management to control the infection and reduce the outbreak risk of HAI.METHODS From Feb.to Jun.2017,the HAI management training base in Guizhou province recruited medical institutions to research on the hospital infection risks,held the training and apply the plan step by step.A baseline survey,the hospital level evaluation,department level assessment,a three-month intervention on high-risk link and effect evaluation were made.RESULTS Risks in 47 medical institutions in Guizhou were assessed on the hospital level and department level,of which 18 medical institutions were identified as homogeneity,with the non-normal distribution score frequency of clinical risk assessment.The risk of infection in 75.3%of the clinical departments was median or low.The highest risk of infection department was neurosurgery ICU,with the score of 156.0.The top 10 highest risk departments included four hospital ICU,four hospital neurosurgery and 2 hospital neurosurgery ICU.Thirty-two medical institutions carried out the high-risk intervention in high-risk departments.There were 8119 cases observed in the pre-intervention group and 9279 cases observed in the post-intervention group.By comparing the pre-intervention group and post-intervention group,the incidence of HAI reduced from 3.806%to 1.908%,and the incidence case/time of HAI reduced from 4.175%to 1.972%.The differences between them were statistically significant.CONCLUSION Medical institutions in Guizhou province carried out the HAI risk management model,and evaluated hierarchically from the hospital level and department level to identify the key departments and links.Precise intervention can effectively control and reduce the incidence of HAI,which may play a great role in promoting the prevention and control of HAI in our province.

关 键 词：医疗机构 医院感染 风险管理 实施 运用 

分 类 号：R183[医药卫生—流行病学]