弹性调配病区的环境多维特征——一项前瞻性真实世界研究  

Environmental multidimensional characteristics of a flexible deployment ward:a prospective real-world study

作　　者：陈诺 浮钰琪 刘荔 何文斌 冯毕龙 陈小艳[5] 彭涵之[6] 李妍 邬闻文 王莹[3,7] CHEN Nuo;FU Yuqi;LIU Li;HE Wenbin;FENG Bilong;CHEN Xiaoyan;PENG Hanzhi;LI Yan;WU Wenwen;WANG Ying(Public Health and Wellness,Hubei University of Medicine,Shiyan,Hubei 442000,P.R.China;Department of Architectural Technology and Science,School of Architecture,Tsinghua University,Beijing 100084,P.R.China;Hubei Engineering Research Center for Precision Prevention,Control,Diagnosis and Treatment of Infectious Diseases,Wuhan,Hubei 430071,P.R.China;Department of Colorectal Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,P.R.China;Nursing Department,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,P.R.China;Center for Global Health Research,Duke Kunshan University,Kunshan,Jiangsu 215316,P.R.China;Department of Healthcare-associated Infection Management,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,P.R.China;Hubei Province Hypertension Clinical Medical Research Center,Shiyan,Hubei 442000,P.R.China)

机构地区：[1]湖北医药学院公共卫生与健康学院,湖北十堰442000 [2]清华大学建筑学院建筑技术科学系,北京100084 [3]感染性疾病精准防控与诊治湖北省工程研究中心,武汉430071 [4]武汉大学中南医院结直肠肛门外科,武汉430071 [5]武汉大学中南医院护理部,武汉430071 [6]昆山杜克大学全球健康研究中心,江苏昆山215316 [7]武汉大学中南医院医院感染管理办公室,武汉430071 [8]湖北省高血压临床医学研究中心,湖北十堰442000

出　　处：《华西医学》2024年第3期367-372,共6页West China Medical Journal

基　　金：国家自然科学基金(52178080);国家卫生健康委医院管理研究所“感研”种子项目(GY2023049)。

摘　　要：目的对比弹性调配病区时临时扩展医疗区域与常态化区域环境微生物与物理监测参数,总结规律并寻找潜在医院感染防控风险点。方法于2023年4月10日—23日在武汉大学中南医院病区内开展前瞻性环境微生物及物理参数监测,对比分析不同场景下的监测结果。结果通常情况下,临时医疗区域二氧化碳浓度、细颗粒物(particulate matter 2.5,PM_(2.5))浓度、温度、相对湿度均低于病室内(P<0.05),两个区域表面微生物和医务人员手部微生物检出量差异无统计学意义(P>0.05)。临时医疗区域启动时,病室内表面微生物检出量、二氧化碳浓度、温度高于临时医疗区域(P<0.05),PM_(2.5)浓度低于临时医疗区域(P<0.05),医务人员手部微生物检出量和相对湿度差异无统计学意义(P>0.05)。与未启动时相比,临时医疗区域启动时病室内空气微生物检出量、二氧化碳浓度、温度、相对湿度降低(P<0.05),环境物体表面微生物检出量、PM_(2.5)浓度升高(P<0.05),医务人员手部微生物检出量差异无统计学意义(P>0.05);临时医疗区域内PM_(2.5)比未启动时高(P<0.05),二氧化碳浓度、温度比未启动时低(P<0.05),两个时期表面微生物和医务人员手部微生物检出量及相对湿度差异无统计学意义(P>0.05)。此外,无论临时医疗区域是否启动,空气样本中微生物检出率最高的均为丝状真菌,环境物体表面样本和医务人员手样本中微生物检出率最高的均为表皮葡萄球菌。结论临时医疗区域所带来的环境微生物负荷、通风不佳等系列环境风险应引起关注。Objective To compare the environmental microbiological and physical monitoring parameters between the temporary extended medical area and the normal area during the flexible allocation of ward,summarize the rule and find the potential risk points of infection control.Methods From April 10th to 23rd,2023,prospective environmental microbial monitoring and physical parameter monitoring were carried out in a ward of Zhongnan Hospital of Wuhan University,and the monitoring results under different scenarios were compared and analyzed.Results In general,the carbon dioxide(CO2)concentration,particulate matter 2.5(PM_(2.5))concentration,temperature,and relative humidity in the temporary medical area were better than those in the inpatient rooms(P<0.05),but there was no statistically significant difference in the amount of microorganisms detected on the surface of environmental objects or the hands of medical staff(P>0.05).After the start of the temporary medical area,the amount of microorganisms detected on the surface of environmental objects,CO2 concentration,and temperature in the inpatient rooms were higher than those in the temporary medical area(P<0.05),the PM_(2.5)concentration in the inpatient rooms was lower than that in the temporary medical area(P<0.05),and there was no statistically significant difference in the amount of microorganisms detected on the hands of medical staff or relative humidity between the two areas(P>0.05).Compared with those in the same area when the temporary medical area was not started,in the inpatient rooms after the start,the amount of microorganisms detected in the air,CO2 concentration,temperature,and relative humidity were lower(P<0.05),the amount of microorganisms detected on the surface of environmental objects and PM_(2.5)concentration were higher(P<0.05),and there was no statistically significant difference in the amount of microorganisms detected on the hands of medical staff between the two periods(P>0.05);in the temporary medical area after the start,the PM_(2.5)concentration

关 键 词：弹性调配病区 环境特征 环境监测 前瞻性研究 

分 类 号：R197.32[医药卫生—卫生事业管理]