基于三管监测背景下重症监护室医疗器械感染控制管理的对策研究  

Study of the countermeasures on ICU medical instruments infection control management based on the background of three-tube monitoring

作　　者：陈俪萍 符小玲[1] 邓超[2] 郑永先 陈丹丹[2] CHEN Li-ping;FU Xiao-ling;DENG Chao(Department of Emergency Medicine,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院急诊医学部,海南海口570208 [2]中南大学湘雅医学院附属海口医院重症医学科,海南海口570208

出　　处：《中国医学装备》2022年第4期154-158,共5页China Medical Equipment

摘　　要：目的:构建重症监护室(ICU)医疗器械感染控制管理体系,探讨导管相关血流感染、导尿管相关性尿路感染和呼吸机相关性肺炎监测(三管监测)背景下ICU医疗器械感染控制管理路径与价值。方法:选取医院急诊科接治的242例ICU住院患者,按照管理模式将其分为对照组(117例)和观察组(125例),对照组采用常规护理干预管理模式,观察组采用ICU医疗器械感染控制管理体系的全过程干预管理模式。对比两组危重患者感染控制效果、医疗器械感染控制效果和“三管监测”临床服务质量满意度的差异性。结果:观察组Ⅰ级和Ⅱ级危重患者感染率低于对照组,差异有统计学意义(χ^(2)=4.590,χ^(2)=5.119;P<0.05);观察组使用中心静脉管、导尿管和呼吸机相关感染率低于对照组,差异有统计学意义(χ^(2)=6.817,χ^(2)=8.413,χ^(2)=7.111;P<0.05);ICU主治医生、责任护士、患者和医学工程师对观察组监测服务质量满意度高于对照组,差异有统计学意义(t=3.383,t=8.317,t=9.612,t=3.839;P<0.05)。结论:ICU医疗器械感染控制管理体系的全过程干预管理模式能有效识别感染风险因素的影响程度,降低危重症患者感染发生率,提高医疗器械临床管理质量。Objective:To establish a medical instrument infection control management system for intensive care unit(ICU),and to explore the path and value of infection control management of medical instruments in ICU under the background of three-tube monitoring.Methods:A total of 242 ICU patients admitted to hospital emergency department were selected and divided into control group(117 cases)and observation group(125 cases)according to the management mode.The control group adopted the routine nursing intervention management mode,and the observation group adopted the whole-process intervention management mode of ICU medical instrument infection control management system.The difference on infection control effectiveness of critical patients,infection control effectiveness of medical instruments and clinical service quality of three-tube monitoring were compared between the two groups.Results:The infection rate of grade I and grade II critical patients in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=4.590,χ^(2)=5.119;P<0.05);the infection rate associated with central venous catheter,urinary catheter and ventilator in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=6.817,χ^(2)=8.413,χ^(2)=7.111;P<0.05);the satisfaction of the ICU attending doctors,duty nurses,patients and medical engineers with monitoring service quality of the observation group was higher than that of in the control group,the difference was statistically significant(t=3.383,t=8.317,t=9.612,t=3.839;P<0.05).Conclusion:The whole-process intervention management mode of ICU medical instrument infection control management system can effectively identify the influence degree of infection risk factors,reduce the infection rate of in critical patients,and improve the quality of medical instruments clinical service.

关 键 词：三管监测 医疗器械 重症监护室 感染率 呼吸机相关性肺炎 

分 类 号：R197.39[医药卫生—卫生事业管理]