集束化干预措施对综合ICU医院感染发生率的影响  

Impact of bundles of care on incidence of nosocomial infection in a general ICU

作　　者：胡倩倩 乔甫[2] 徐强 HU Qian-qian;QIAO Fu;XU Qiang(Xingyi People's Hospital in Guizhou Province,Xingyi,Guizhou 562400,China;不详)

机构地区：[1]贵州省兴义市人民医院医院感染管理科,贵州兴义562400 [2]四川大学华西医院医院感染管理部,四川成都610000 [3]贵州省兴义市人民医院医院重症医学科,贵州兴义562400

出　　处：《中华医院感染学杂志》2024年第18期2812-2816,共5页Chinese Journal of Nosocomiology

基　　金：国家卫生健康委卫生发展研究中心研究课题(2020-53)。

摘　　要：目的评价集束化干预措施对综合重症监护室(ICU)医院感染发生率的影响。方法本研究采用前后比较的类实验性研究设计,根据纳入和排除标准选取2021年8月-2022年7月入住综合ICU患者为对照组、2022年8月-2023年7月入住综合ICU患者为干预组。干预组在常规管理基础上实施集束化感染防控干预措施,对干预前后医院感染发生情况进行统计分析。结果对照组和干预组分别纳入1089例和895例患者,对照组急性生理与慢性健康Ⅱ(APACHEⅡ)评分[20(14,24)]与干预组[20(14,25)]相似(Z=-0.907,P=0.365);干预组医院感染发病率低于对照组(2.35%vs.4.50%,χ^(2)=6.691,P=0.010),其中干预组下呼吸道感染、血流感染发病率和导尿管相关尿路感染发生率均低于对照组(0.67%vs.1.93%,χ^(2)=5.791,P=0.016;0.11%vs.1.38%,χ^(2)=9.838,P=0.002;0.800例/1000导管日vs.2.448例/1000导管日,U=2.202,P=0.028),其他部位的医院感染发生率无统计学差异。结论集束化干预措施可有效降低综合ICU的医院感染发生率,特别是下呼吸道感染、血流感染和导尿管相关尿路感染发生率。OBJECTIVE To evaluate the impact of bundles of care on the incidence of nosocomial infection in a general Intensive care unit(ICU).METHODS By means of a quasi-experimental design with a pre-and post-comparison approach,the patients who were hospitalized in general ICU from Aug 2021 to Jul 2022 were assigned as the control group according to inclusion and exclusion criteria,and the patients who were hospitalized in general ICU from Aug 2022 to Jul 2023 were assigned as the intervention group.The bundles of prevention and control intervention measures for infections were taken in the intervention group on basis of the conventional management.The incidence of nosocomial infection was statistically analyzed before and after the intervention.RESULTS There were 1089 patients in the control group and 895 patients in the intervention group.The Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱscore of the control group was[20(14,24)],similar to[20(14,25)]of the intervention group(Z=-0.907,P=0.365).The incidence of nosocomial infection of the intervention group was 2.35%,lower than 4.50%of the control group(χ^(2)=6.691,P=0.010).The incidence of lower respiratory tract infection of the intervention group was 0.67%,lower than 1.93%of the control group(χ^(2)=5.791,P=0.016);the incidence of bloodstream infection of the intervention group was 0.11%,lower than 1.38%of the control group(χ^(2)=9.838,P=0.002);the incidence of urinary catheter-related urinary tract infection of the intervention group was 0.800 case/1000 catheter day,lower than 2.448 case/1000 catheter day of the control group(U=2.202,P=0.028).There were no significant differences in the incidence rates of nosocomial infections of other sites.CONCLUSION The bundles of care can effectively reduce the incidence of nosocomial infection in the general ICU,especially the incidence of lower respiratory tract infection,bloodstream infection and urinary catheter-related urinary tract infection.

关 键 词：集束化 干预措施 重症监护室 医院感染 

分 类 号：R184[医药卫生—流行病学]