多层级多学科综合治疗模式对院内感染防控的结果分析  

Analysis on the prevention and control effect of multi-level and multi-disciplinarity comprehensive treatment model on hospital infection

作　　者：邓晓辉[1] 康亚辉 贺锐[1] 方惠娟[1] 李甫云 代伟[1] DENG Xiao-Hui;KANG Ya-Hui;HE Rui(Gansu Maternal and Child Health Care Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省妇幼保健院,甘肃兰州730050

出　　处：《中国妇幼保健》2022年第13期2493-2496,共4页Maternal and Child Health Care of China

基　　金：甘肃省科技计划项目(20YF3FA013)。

摘　　要：目的 探讨多层级多学科综合治疗(MDT)协同监管新模式对妇幼保健院内多重耐药菌(MDRO)感染防控的效果,为医疗机构精细化、高效防控提供方法学指导。方法 选取2018年7月—2019年6月甘肃省妇幼保健院收治的感染患者354例为对照组,2019年7月—2020年6月收治的感染患者338例为观察组。应用新模式完善微生物标本规范采集送检、危急值报告、处置及多学科诊疗等多个环节流程,比较前后各项质量评价指标的差异。结果 应用新模式后,MDRO医院感染发生率由0.44%下降至0.35%,检出率由3.10%~43.48%下降至1.04%~18.47%,差异均有统计学意义(均P<0.05)。MDRO各项防控措施依从率和知晓率由62.99%~81.92%提升至81.65%~92.01%;抗菌药物使用率从45.50%下降至38.87%,治疗性抗菌药物使用前微生物标本送检率从73.71%上升至94.53%。结论 多层级MDT协同监管新模式完善了整体防控内容,增强了各层级中各部门参与合作程度,发挥了学科间优势互补,提高了MDRO感染防控效果。Objective To explore the prevention and control effect of multi-level and multi-disciplinarity comprehensive treatment(MDT) combined with synergetic supervision new model on multidrug-resistant bacterial(MDRO) infection in Maternal and Child Health Care Hospital, provide methodological guidance for elaborative and efficient prevention and control in medical institutions. Methods From July 2018 to June 2019, 354 patients with infection treated in Gansu Maternal and Child Health Care Hospital were selected as control group;from July 2019 to June 2020, 338 patients with infection treated in Gansu Maternal and Child Health Care Hospital were selected as observation group. New model was used to perfect process of multiple links, including specimen collection and submission of microbial specimens, report and management of critical value, and multi-disciplinary diagnosis and treatment. The differences of various quality evaluation indexes before and after new model were compared.Results After application of new model, the incidence rate of MDRO hospital infection decreased from 0.44% to 0.35%, the detection rate decreased from 3.10%-43.48% to 1.04%-18.47%, there were statistically significant differences(P<0.05).The compliance rate and awareness rate of various prevention and control measures for MDRO increased from 62.99%-81.92% to 81.65%-92.01%. The utilization rate of antibacterial drugs decreased from 45.50% to 38.87%, the submission rate of microbial specimens before application of antibacterial drugs increased from 73.71% to 94.53%. Conclusion Multi-level MDT collaborative supervision new model improves the overall prevention and control content, enhances the degree of participation and cooperation of various departments, takes advantage of the complementary advantages of disciplines, and improves the prevention and control effect of MDRO infection.

关 键 词：多层级 多学科综合治疗 妇幼保健院 协同监管 多重耐药菌 

分 类 号：R197.32[医药卫生—卫生事业管理]