机构地区：[1]南京医科大学第二附属医院感染管理办公室,江苏南京210011 [2]南京医科大学第一附属医院感染管理处,江苏南京210029 [3]常州市第一人民医院感染管理科,江苏常州213004 [4]启东市人民医院感染管理科,江苏南通226299 [5]宿迁市第一人民医院感染管理科,江苏宿迁223899 [6]连云港市第一人民医院感染管理科,江苏连云港222002 [7]无锡市第二人民医院感染管理科,江苏无锡214002 [8]泰州市人民医院感染管理科,江苏泰州225399 [9]苏州市立医院感染管理科,江苏苏州215008 [10]淮安市第一人民医院感染管理科,江苏淮安223399 [11]常州市第二人民医院感染管理科,江苏常州213004 [12]镇江市第一人民医院感染管理科,江苏镇江212002 [13]南通市第一人民医院感染管理科,江苏南通226006 [14]江苏大学附属医院感染管理科,江苏镇江212008 [15]江苏省苏北人民医院感染管理科,江苏扬州225001 [16]江南大学附属医院感染管理科,江苏无锡214122 [17]盐城市第一人民医院感染管理科,江苏盐城224006 [18]扬州大学附属医院感染管理科,江苏扬州225000 [19]徐州市第一人民医院感染管理科,江苏徐州221006 [20]南京鼓楼医院感染管理科,江苏南京210008
出 处：《中华医院感染学杂志》2023年第24期3791-3796,共6页Chinese Journal of Nosocomiology
基 金：国家卫生健康委卫生发展研究中心感控循证研究项目(2020-53)。
摘 要：目的调查血管导管相关感染(VCAI)防控实施现状,为进一步推动新指南落实、制定符合临床实际的置管操作及维护核查表等提供依据。方法采用横断面调查方法,根据《血管导管相关感染预防与控制指南(2021版)》设计调查问卷,于2022年6-9月对江苏省20家三级医院进行在线问卷调查。调查内容包括医疗机构血管导管相关感染预防与控制指南推行情况,个案调查包括重点部门成年患者置管防控措施落实情况。结果共纳入20家三级医院2895例患者,75.0%(15/20)医院向临床医护提供置管核查表,83.2%(2410/2895)置管及维护人员接受过VCAI指南培训;置管前,16.2%(469/2895)置管环境不符合规范(Ⅲ类或Ⅳ类环境);70.3%(324/461)输液港植入在手术室进行;9.0%(260/2895)置管部位为股静脉;置管中,97.2%(2814/2895)遵循最大无菌屏障要求;仅10.8%(314/2895)使用含氯己定醇的皮肤消毒剂消毒穿刺部位;置管后,39.9%(1154/2895)应用三通旋塞阀进行导管连接;50.3%(364/723)输注静脉内脂肪剂(IVFE)时每隔12 h更换输液装置;亚组分析显示,置管部位、最大无菌屏障、皮肤消毒剂类型、导管连接方式、输注IVFE时更换管路频率在ICU与非ICU病区分布差异具有统计学意义(P<0.05)。结论VCAI预防与控制措施培训及落实情况需进一步加强,迫切需要制定切合实际、可执行的核查表以督促防控措施进一步实施。OBJECTIVE To investigate the current situation of the prevention and control of vascular catheter associated infections(VCAI), and to provide the basis for further promoting the implementation of new guidelines and formulating the catheter operation and maintenance checklist in line with clinical practice. METHODS A cross-sectional survey was conducted in 20 tertiary hospitals by on-line questionnaire designed according to the guidelines for the prevention and control of vessel catheter associated infections(2021 version) in Jiangsu Province from Jun to Sep 2022. The survey included the implementation of guidelines for the prevention and control of vessel catheter associated infection in medical institutions, and the case study included the implementation of prevention and control measures for adult patients in key departments. RESULTS A total of 2 895 patients from 20 tertiary hospitals were included. 75.0%(15/20) of the hospitals provided catheterization checklists to clinical doctors and nurses, and catheterization and maintenance personnel in 83.2%(2 410/2 895) of cases received VCAI guidance training. Before catheterization, 16.2%(469/2 895) of the catheterization environment did not meet the standard(Class III or class IV environment);70.3%(324/461) of the port-cath was implanted in the operating room;9.0%(260/2 895) of patients were placed in femoral vein. During catheterization, 97.2%(2 814/2 895) of healthcare personnel used maximum sterile barrier(MSB) precautions;only 10.8%(314/2 895) of them cleaned the puncture sites of the skin with chlorhexidine preparations with alcohol. After catheterization, 39.9%(1 154/2 895) of healthcare personnel used three-way plug valve for catheter connection;50.3%(364/723) changed the infusion device every 12 hours when the patients were administered with intravenous fat emulsion(IVFE). Subgroup analysis showed that there were significant differences in the distribution of catheter locations, the largest sterile barriers, the types of skin disinfectant, catheter connecti
关 键 词：血管导管相关感染 指南 现状 核查表 三级医院 横断面研究 现况调查 问卷调查
分 类 号：R197[医药卫生—卫生事业管理]
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