基于三级网络管理模式的医院感染防控网格化实践及效果评价  

Practice of grid management for prevention and control of nosocomial infection based on three-level network and its effect evaluation

作　　者：吕建峰 贾丽燕[2] 王林娟[1] 王清秀[1] 邓爱军[1] LYU Jian-feng;JIA Li-yan;WANG Lin-juan;WANG Qing-xiu;DENG Ai-jun(Affiliated Hospital of Weifang Medical University,Weifang,Shandong 261000,China)

机构地区：[1]潍坊医学院附属医院感染管理办公室,山东潍坊261000 [2]潍坊医学院附属医院条件保障部,山东潍坊261000

出　　处：《中华医院感染学杂志》2023年第12期1895-1899,共5页Chinese Journal of Nosocomiology

摘　　要：目的 构建基于三级网络管理模式下的医院感染防控网格化管理体系,开展医院感染防控网格化实践,并对其成效开展效果评价。方法 2018年以来,某三级甲等综合性医院积极借鉴网格化管理理念,构建医院感染防控网格化管理体系,通过划分感控网格、明确感控网格管理人员职责、多维度、多层面量化履职考核、开展系统化感控培训、加强信息化建设、优化医院感染管理质量考核指标体系等一系列举措,比较网格化体系实践前后医院感染管理质量考核指标变化趋势,评估医院感染管理质量。结果 医院感染防控网格化体系实践后,医院感染发生率由1.23%下降至0.9%,医院感染现患率由2.45%下降至2.01%,医院感染漏报率由5.72%下降至1.74%,医务人员手卫生依从率由56.18%提高至89.24%,医务人员手卫生正确率由69.58%提高至86.34%,住院患者抗菌药物使用率由50.40%下降至39.91%,抗菌药物使用前病原学送检率由48.95%提高至59.44%,导尿管相关泌尿道感染发病率由1.63‰下降至0.52‰,差异均有统计学意义(P<0.05)。多药耐药菌检出率由14.03%降至10.66%,环境卫生学监测合格率由99.25%提高至99.31%,Ⅰ类切口抗菌药物预防使用率由14.16%降至12.86%(P<0.05)。结论 通过基于三级网络管理模式的医院感染防控网格化体系的构建与实践,医院感染防控能力持续提升,医院感染管理质量显著提高。OBJECTIVE To build the grid management system for prevention and control of nosocomial infection based on three-level network,carry out the practice of grid management of nosocomial infection prevention and control,and evaluate its effectiveness.METHODS Since 2018,a grade III-A general hospital had actively drawn on the concept of grid management to build the grid management system for prevention and control of hospital infection.Through a series of measures such as dividing the grid cells for hospital infection control,clarifying the responsibilities of grid administrators for hospital infection control,quantifying performance assessment in multi-dimensional and multi-level,conducting systematic sentinel control training,strengthening information construction and optimizing the quality assessment system of hospital infection management,the trends of changes in nosocomial infection management quality indicators were compared before and after the practice of grid management to evaluate the quality of nosocomial infection management.RESULTS After the practice of grid management for the prevention and control of nosocomial infection,the incidence of nosocomial infection decreased from 1.23% to 0.9%,the prevalence rate of nosocomial infection decreased from 2.45% to 2.01%,the underreporting rate of nosocomial infection decreased from 5.72% to 1.74%.The compliance rate of hand hygiene among medical staff increased from 56.18% to 89.24%,the correct rate of hand hygiene among medical workers increased from 69.58% to 86.34%.The rate of antibiotics use decreased from 50.40% to 39.91%,the rate of etiology examination for therapeutic usage increased from 48.95% to 59.44%,and the incidence of catheter-related urinary tract infection dropped from 1.63 to 0.52 per thousand.The differences in trends of above indicators were statistically significant(P<0.05).The detection rate of multidrug-resistant organisms decreased from 14.03% to 10.66%,the qualified rate of environmental hygiene monitoring increased from 99.25% to 99.31%,an

关 键 词：医院感染防控 三级网络 网格化管理 感控人员 

分 类 号：R187[医药卫生—流行病学]