优化患者外出检查流程在多重耐药菌医院感染防控中的作用  

The role of optimizing the procedures of going out for examination in the prevention and control of multidrug-resistant organism in nosocomial infection

作　　者：唐桂芬 陈国建 徐世兰[3] TANG Guifen;CHEN Guojian;XU Shilan(Central Transportation Department,Shangjin Nanfu Hospital,Chengdu,Sichuan 611731,P.R.China;Department of Hospital Infection Management,Shangjin Nanfu Hospital,Chengdu,Sichuan 611731,P.R.China;Infection Management Department,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]成都上锦南府医院中央运输科,成都611731 [2]成都上锦南府医院医院感染管理科,成都611731 [3]四川大学华西医院感染管理部,成都610041

出　　处：《华西医学》2021年第3期369-373,共5页West China Medical Journal

摘　　要：目的通过优化多重耐药菌患者外出检查流程,加强医院感染防控管理,预防医院感染发生。方法选择2018年4月—11月住院患者中外出检查的多重耐药菌患者为研究对象。其中,2018年4月—7月(实施前)为流程建造阶段,2018年8月—11月(实施后)是流程优化实施阶段。于2018年4月制定多重耐药菌患者外出检查流程和管理制度,加强运输员培训,落实检查单标识、患者陪检和交接、隔离防护及用物的消毒处理等措施,实现对多重耐药菌患者外出检查的全过程感染防控管理。比较实施前后相关指标。结果共纳入多重耐药菌患者外出检查262例次,实施前134例次,实施后128例次。手卫生,戴手套,仪器物品的消毒处理,患者转运、候检过程的隔离措施(电梯专用、候检隔离、检查时间安排合理),教育培训等多重耐药菌感染防控措施的落实及效果均有提升(P<0.05)。耐甲氧西林金黄色葡萄球菌检出率实施前后比较,差异有统计学意义(P<0.05)。结论多重耐药菌患者外出检查流程的优化可提高多重耐药菌医院感染防控中手卫生、物表消毒、接触隔离防护、教育培训等间接指标执行率,对多学科协作的多重耐药菌集束化防控管理有重要意义。Objective To optimize procedures of going out for examination for patients with multidrug-resistant organism, strengthen prevention and control management of nosocomial infection, and prevent nosocomial infection.Methods Patients with multidrug-resistant organism who went out for examination were selected from April to November 2018. April to July 2018(before implementation) was process construction stage, and August to November 2018(after implementation) was process optimization implementation stage. In April 2018, process and management system of going out for multidrug-resistant organism patients were formulated, training of transporters was strengthened, and measures such as checklist identification, accompany patients for examination, patient handover, isolation and protection,and disinfection of materials were implemented, to realize the infection prevention and control management in the whole process of going out for multidrug-resistant organism patients. We compared relevant indicators before and after implementation. Results A total of 262 cases times of patients with multidrug-resistant organism were included, including134 cases times before implementation and 128 cases times after implementation. Compared with before implementation,the hand hygiene, wearing gloves, disinfection of inspection instruments and articles, patient transfer, isolation measures in waiting process(special elevator, isolation after waiting for inspection, arrange inspection time reasonably), education and training after implementation improved(P<0.05). Before and after implementation, the Methicillin resistant staphylococcus aureus detection rate difference was statistically significant(P<0.05). Conclusions The optimization of procedures of examination for patients with multidrug-resistant organism can increase implementation rate of indirect indicators such as hand hygiene, disinfection of inspection instruments and articles, isolation and protection, education and training in the prevention and control of multidrug-resistant o

关 键 词：多重耐药菌 外出检查 中央运输 医院感染防控 

分 类 号：R197.323[医药卫生—卫生事业管理]