重症监护室医院感染风险评估体系的构建研究  

Research on Construction of Nosocomial Infection Risk Assessment System in Intensive Care Unit

作　　者：孙艳[1] 张德厚[2] 赵燕燕[2] 马旻轩 伍彬 邢虎[1] SUN Yan;ZHANG Dehou;ZHAO Yanyan;MA Mingxuan;WU Bin;XING Hu(Department of Infection Management,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212000,China;Department of Intensive Care Unit,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212000,China)

机构地区：[1]江苏大学附属医院感染管理科,江苏镇江212000 [2]江苏大学附属医院重症监护室,江苏镇江212000

出　　处：《中国卫生标准管理》2021年第21期118-121,共4页China Health Standard Management

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-2-2019-13)。

摘　　要：目的通过对某三甲医院重症监护室风险评估模型的构建,以期为全院各科室的感染管理工作提供借鉴,提升医院的整体抗风险能力,减少危机发生。方法采用文献研究、专家头脑风暴、调查法进行医院感染管理风险识别,遵循失效模式和效应分析法(failure mode effect analysis,FMEA技术),分别从“发生可能性、如果发生潜在的严重性、应对此风险的能力及体系”三方面进行评价,确定权重系数,建立重症监护室医院感染控制风险评估表。结果筛选出风险等级为极高和高的指标,按风险高低排序分别为:多重耐药菌防控流程不规范、医院感染率高、多重耐药菌感染发生率高、手卫生依从率低和医院感染管理制度不健全。结论对医院内院感风险较高科室进行系统研究,一方面掌握重症监护室院感相关因素和关键控制措施,并采取相应措施降低医院感染发病率,另一方面探索该方法在医院中其他院感重点科室以及全院层面中的应用。Objective To provide a reference for the infection management of the various departments of the hospital,improve the overall anti-risk ability of the hospital and reduce the occurrence of crises through the construction of a risk assessment model for the intensive care unit in a three-A hospital.Methods Risk identification relies on the use of literature research,expert brainstorming,investigation methods,and following FMEA technology(failure mode effect analysis).The possibility of risk,severity of consequence,and current system were comprehensively evaluated and assigned,the weight coefficient was determined,and a risk assessment form for hospital infection control in the intensive care unit was established.Results Screening out indicators of extremely high and high risk ratings,the results were as follows:non-standard procedures for the prevention and control of multi-drug resistant bacteria,high occurrence of nosocomial infection,high occurrence of MDRO nosocomial infection,lack of hand hygiene and incomplete nosocomial infection management rules.Conclusion To make a systematic study on the departments with higher risk of nosocomial infection,on the one hand,to grasp the related factors and key control measures of intensive-care unit,and to take corresponding measures to reduce the incidence of nosocomial infection,on the other hand,the application of this method in other key departments of hospital sense as well as in the whole hospital was explored.

关 键 词：医院感染 风险评估 重症监护室 研究 失效模式和效应分析法 权重 

分 类 号：R619[医药卫生—外科学]