多学科合作医院感染查房管理模式在MDROs医院感染控制中的效果  

Effectiveness of multidisciplinary collaborative hospital infection rounds management model in MDROs hospital infection control

作　　者：朱东林[1] 葛昀 刘德丰[2] 陆强[3] 刘天植 刘秀娟[1] ZHU Dong-lin;GE Yun;LIU De-feng;LU Qiang;LIU Tian-zhi;LIU Xiu-juan(Qinhuangdao First Hospital of Hebei Province,Qinhuangdao,Hebei 066000,China)

机构地区：[1]河北省秦皇岛市第一医院医院感染管理处,河北秦皇岛066000 [2]河北省秦皇岛市第一医院医院影像中心,河北秦皇岛066000 [3]河北省秦皇岛市第一医院医院内分泌科,河北秦皇岛066000 [4]河北省秦皇岛市第一医院医院重症医学科,河北秦皇岛066000

出　　处：《中华医院感染学杂志》2024年第20期3132-3136,共5页Chinese Journal of Nosocomiology

基　　金：河北省中央引导地方科技发展资金项目(236Z7703G)。

摘　　要：目的分析应用多学科合作医院感染查房管理模式在多药耐药菌(MDROs)医院感染控制中的效果。方法选取河北省秦皇岛市第一医院2022年1-12月收治的90153例患者作为研究组,收集在多学科合作医院感染查房管理模式下MDROs监测数据及防控措施落实情况,选取2021年1-12月的81347例患者作为对照组,收集在科室常规管理下MDROs监测数据及防控措施落实情况;观察两组MDROs防控措施落实率和MDROs医院感染发病率。结果实施多学科合作医院感染查房模式后医务人员隔离标识、手卫生、物品专用及消毒、环境清洁消毒、科室培训及早交班、转科或手术告知、接触/解除隔离医嘱、个人防护、医疗废物和织物正确处置等防控措施的执行率分别为98.65%、97.03%、95.41%、97.30%、99.05%、98.24%、93.65%、99.19%均高于实施前(P<0.05);实施医院感染查房模式后MDROs检出率为51.99%低于实施前(P<0.001);实施后的MDROs医院感染率为0.02%低于实施前(P<0.001)。结论将多学科合作医院感染查房模式应用到MDROs医院感染控制中,能提高MDROs各项防控措施的落实,降低在院患者MDROs检出率,降低MDROs医院感染的发生率,对于MDROs医院感染管理具有显著效果和积极意义。OBJECTIVE To analyze the effectiveness of a multidisciplinary collaborative hospital infection rounds management model in hospital infection control of MDROs.METHODS Totally 90,153 patients admitted to the hospital from Jan.to Dec.2022 were selected as the study group to collected the MDROs monitoring data and the implementation of prevention and control measures under the multidisciplinary joint hospital infection ward round management mode,and 81,347 patients from Jan.to Dec.2021 were selected as the control group to collect the MDROs monitoring data and the implementation of prevention and control measures under the routine manage-ment of the department.The implementation rate of MDROs prevention and control measures and the incidence rate of MDROs nosocomial infection in different management modes between two groups were compared.RESULTS The implementation rates of prevention and control measures such as isolation labels,hand hygiene,item specific and disinfection,environmental cleaning and disinfection,training and handing-off,transfer of clinical department or transfer of surgery,contact/release of isolation orders,personal protection,and correct disposal of medical waste and fabrics for medical staff after implementing the multidisciplinary cooperative hospital infection rounds model were 98.65%,97.03%,95.41%,97.30%,99.05%,98.24%,93.65%and 99.19%,respectively,higher than those before implementation(P<0.05).The detection rate of MDROs after implementing the hospital infection rounds was 51.99%,lower than before implementation(P=0.001).The hospital infection rate of MDROs after implementation was 0.02%,which was lower than that before implementation(P=0.001).CONCLUSION The application of the multidisciplinary combined hospital infection ward round mode in the infection control of MDROs hospital could improve the implementation of various prevention and control measures of multi-drug resistant bacteria,reduce the detection rate of MDROs in hospital patients and the occurrence of MDROs nosocomial infection,whi

关 键 词：医院感染查房管理模式 多药耐药菌 医院感染 

分 类 号：R183[医药卫生—流行病学]