持续质量改进在肝移植病房多重耐药菌医院感染防控中的应用效果  

Application effect of continuous quality improvement in prevention and control of nosocomial infection caused by multidrug-resistant bacteria in liver transplant wards

作　　者：冷自如 吴薇 黄春美 LENG Ziru;WU Wei;HUANG Chunmei(School of Nursing,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China;Department of Hospital Infection Control,Shulan(Hangzhou)Hospital,Hangzhou,Zhejiang 310022,China;Department of Hospital Infection Control,Tongde Hospital of Zhejiang Province,Hangzhou,Zhejiang 310012,China)

机构地区：[1]浙江中医药大学护理学院,浙江杭州310053 [2]树兰(杭州)医院院感科,浙江杭州310022 [3]浙江省立同德医院院感科,浙江杭州310012

出　　处：《医药前沿》2025年第5期11-14,共4页Journal of Frontiers of Medicine

基　　金：2022年浙江省中医药科技计划(2022ZA042)。

摘　　要：目的观察持续质量改进在肝移植病房多重耐药菌医院感染防控中的应用效果。方法选取树兰(杭州)医院肝移植病房2023年1—12月1905例患者为研究对象,2023年1—6月未实施持续质量改进(对照组),2023年7—12月实施持续质量改进(观察组)。通过成立持续质量改进小组,梳理现有流程,查找问题,分析原因,讨论并推进多重耐药菌管理改进策略。比较两组肝移植病房多重耐药菌医院感染率和千日定植率、多重耐药菌隔离措施落实率、手卫生依从性。结果观察组多重耐药菌医院感染率低于对照组,及时开具隔离医嘱、同种病原菌同室隔离或单间隔离、戴手套、转运时双层医废袋、织物分开回收、共用仪器设备用后消毒、外出检查告知、严格终末消毒8项隔离措施落实率高于对照组,各医务群体手卫生依从性和总手卫生依从性均高于对照组,差异有统计学意义(P<0.05)。结论通过持续质量改进,可提高隔离医嘱开具、同种病原菌同室隔离或单间隔离、戴手套等多项接触隔离措施落实率,提高医务群体手卫生依从性,降低肝移植病房患者多重耐药菌医院感染率。Objective To observe the application effect of continuous quality improvement in prevention and control of nosocomial infection caused by multidrug-resistant bacteria in liver transplant wards.Methods A total of 1905 patients in the liver transplant wards of in Shulan(Hangzhou)Hospital from January to December 2023 were selected as the research objects.Continuous quality improvement was not implemented from January to June 2023(control group),and continuous quality improvement was implemented from July to December 2023(observation group).A continuous quality improvement team was established to sort out the existing processes,identify problems,analyze and discuss the causes,and promote the improvement strategies for the management of multidrug-resistant bacteria.The nosocomial infection rate and thousand-day colonization rate of multidrug-resistant bacteria,the implementation rate of isolation measures for multidrug-resistant bacteria,and the compliance rate of hand hygiene in the liver transplant wards were compared between the two groups.Results In the observation group,the nosocomial infection rate of multidrug-resistant bacteria was lower,while the implementation rates of eight isolation measures,including timely issuance of isolation orders,isolation of the patients with the same pathogen in the same room or in the single room,wearing gloves,using double medical waste bags during transportation,separate recycling of fabrics,disinfection of shared instruments and equipment after using,notification for outpatient examinations,and strict terminal disinfection,were higher than those in the control group;the compliance rates of hand hygiene and the overall compliance rate of hand hygiene among various medical staff groups were also higher than those in the control group,the differences were statistically significant(P<0.05).Conclusions Continuous quality improvement may improve the implementation rates of contact isolation measures such as issuing isolation orders,isolating the patients with the same pathogen in t

关 键 词：肝移植 病房 持续质量改进 感染 多重耐药菌 医院感染 预防 

分 类 号：R63[医药卫生—外科学]