项目综合管理策略在重症监护病房耐甲氧西林金黄色葡萄球菌感染防控中的应用  

Application of Integrated Project Management Strategies in Prevention and Control of Methicillin-resistant Staphylococcus aureus Infection in Intensive Care Unit

作　　者：兰天[1] 刘金禄[2] 袁二伟[3] 高晶 李宝亮[2] 贾倩[4] 曹亮[5] 温红梅[6] LAN Tian;LIU Jin-lu;YUAN Er-wei;GAO Jing;LI Bao-liang;JIA Qian;CAO Liang;WEN Hong-mei(Department of Healthcare-associated Infection Control,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Microbiology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Neonatology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Laboratory Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Respiratory and Critical Care Unit,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Blood Purification Center,Hebei North University Affiliated First Hospital,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院感染管理处,河北张家口075000 [2]河北北方学院附属第一医院微生物科,河北张家口075000 [3]河北北方学院附属第一医院新生儿科,河北张家口075000 [4]河北北方学院附属第一医院检验科,河北张家口075000 [5]河北北方学院附属第一医院呼吸与危重症监护病房,河北张家口075000 [6]河北北方学院附属第一医院血液净化中心,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2024年第10期23-27,共5页Journal of Hebei North University:Natural Science Edition

基　　金：河北省医学科学研究课题(No.20210366)。

摘　　要：目的 探讨项目综合管理策略在重症监护病房(ICU)落实耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)感染防控措施中的应用效果,为降低MRSA医院感染发生率提供循证依据。方法 选取2020-01-2021-12月某三甲医院5个ICU中住院患者送检标本并经微生物培养分离出MRSA的患者为研究对象。2020年为基线调查,2021年实施项目综合管理策略。比较干预前后各项防控措施落实执行情况、手卫生依从性、患者MRSA检出情况和MRSA检出科室分布情况。结果 实施项目综合干预管理策略后,MRSA防控措施的落实情况优于干预前,差异有统计学意义(P<0.05)。各类人员手卫生依从性均有提高,差异有统计学意义(P<0.05)。干预后患者MRSA检出率由35.71%降至27.73%。MRSA检出科室分布情况显示除呼吸内科ICU持平,其他ICU检出率均下降。结论 项目综合管理策略提高了MRSA感染防控措施的执行力和有效性,降低了MRSA检出率,减少了患者感染MRSA的风险,可保障医疗安全。Objective To explore the effect of integrated project management strategy in the implementation of methicillin-resistant Staphylococcus aureus(MRSA)infection prevention and control measures in intensive care units(ICUs),and to provide an evidence-based basis for reducing the occurrence of MRSA hospital-acquired infections.Methods Five ICU inpatients with specimens isolated by microbiological culture for MRSA in a tertiary class-A hospital from January 2020 to December 2021 were selected for the study.The condition of 2020 was the baseline survey,and the cluster management strategy was implemented in 2021.The implementation of prevention and control measures,hand hygiene compliance,MRSA detection in patients and the distribution of MRSA detection units were compared before and after the intervention.Results After the implementation of the integrated project management strategy,the implementation of MRSA prevention and control measures was better than that before the intervention,and the difference was statistically significant(P<0.05).Hand hygiene compliance improved for all categories of personnel,with statistically significant differences(P<0.05).The MRSA detection rate decreased from 35.71%to 27.73%in patients after the intervention,and the distribution of MRSA detection departments showed that the detection rate decreased in all ICUs except for the respiratory medicine ICU,which remained flat.Conclusion The integrated project management strategy can effectively improve the implementation and effectiveness of MRSA infection prevention and control measures,reduce the detection rate of MRSA,reduce the risk of MRSA infection in patients,and ensure medical safety.

关 键 词：项目综合管理 耐甲氧西林金黄色葡萄球菌 医院感染 飞行检查 预警机制 重症监护病房 

分 类 号：R473[医药卫生—护理学]