基于三级公立医院绩效考核下的Ⅰ类切口手术部位感染精细化管理  

Refined management of surgical site infection in typeⅠincisions based on the performance assessment of tertiary public hospitals

作　　者：涂丽香 李洪艳 朱晓松 卓凤娟 孙志清[1] TU Lixiang;LI Hongyan;ZHU Xiaosong;ZHUO Fengjuan;SUN Zhiqing(Department of Hospital Infection Management,Linyi People’s Hospital,Shandong,Linyi 276003,China)

机构地区：[1]山东省临沂市人民医院医院感染管理部,山东临沂276003

出　　处：《中国医药科学》2025年第1期174-178,共5页China Medicine And Pharmacy

基　　金：国家自然科学基金资助项目(82003435);国家卫生健康委医院管理研究所“感研”项目(GY2023031-A);山东省自然科学基金资助项目(ZR2020QH332)。

摘　　要：目的基于全国三级公立医院绩效考核背景下,探讨Ⅰ类切口手术部位感染防控精细化管理,以降低Ⅰ类切口手术部位感染率,助力三级公立医院绩效考核中Ⅰ类切口手术部位感染率指标的管理。方法通过医院感染实时监测系统调取2023年1月1日至12月31日临沂市人民医院脊柱外科1821例Ⅰ类切口手术患者病例,收集患者基本信息、手术及感染等相关资料。结果吸烟、合并基础疾病、同期住院总天数、手术时长、尿管插管天数、ASA评分均是脊柱外科患者发生医院感染的危险因素(P<0.05)。42例发生切口感染,感染类型:深部切口36例、浅表切口5例、腔隙感染1例。结论通过加强监测、数据分析及专项督导,针对Ⅰ类切口手术部位感染存在的问题制定相应的整改措施,包括降低Ⅰ类切口手术部位感染具体措施、绩效考核精细化管理、加强科室综合目标管理等,有效降低Ⅰ类切口手术部位感染的发生,2023年三级公立医院绩效考核Ⅰ类切口手术部位感染率指标医院获得满分。Objective Based on the context of performance assessment of tertiary public hospitals across China,to explore the refined management on the prevention and control of surgical site infection in typeⅠincisions,in order to reduce the surgical site infection rate in typeⅠincisions,and to assist in the management of indicators of surgical site infection rate in typeⅠincisions in the performance assessment of tertiary public hospitals.Methods The real-time hospital infection monitoring system was used to retrieve 1,821 patients underwent typeⅠincision surgeries in the Department of Spine Surgery of Linyi People’s Hospital from 1 January to 31 December 2023,and to collect the basic information of the patients,surgery and infection and other related data.Results Smoking,comorbid underlying diseases,total days of hospitalisation during the same period,duration of surgery,days of urinary catheter insertion,and ASA score were risk factors for hospital infections in patients in the Department of Spine Surgery(P<0.05).Incision infections occurred in 42 patients.The types of infection were deep incisions in 36 patients,superficial incisions in 5 patients,and lacunar infection in 1 patient.Conclusion By strengthening monitoring,data analysis and special supervision,and formulating corresponding corrective measures for the problems of surgical site infection in typeⅠincisions,including specific measures to reduce surgical site infection in typeⅠincisions,refined management of performance assessment,and strengthening of the management of comprehensive target across departments,the incidence of surgical site infection in typeⅠincisions is effectively reduced.The hospital received full marks in terms of indicators of surgical site infection rate in typeⅠincisions in the performance assessment of tertiary public hospitals in 2003.

关 键 词：三级公立医院 绩效考核 Ⅰ类切口手术部位感染率 医院感染控制 

分 类 号：R619.3[医药卫生—外科学]