应用系统管理理论提升多院区医院手术部位感染防控效果评价  

Evaluation of the effectiveness of the application of system management theory to improve the prevention and control of surgical site infection in multi-district hospitals

作　　者：谢多双[1] 李丽[1] 彭民金 张爽 胡荍[1] 明星[1] 来瑞平[1] 兰婷钰 孟昆 唐以军[3] XIE Duoshuang;LI Li;PENG Minjin;ZHANG Shuang;HU Qiao;MING Xing;LAI Ruiping;LAN Tingyu;MENG Kun;TANG Yijun(Department of Prevention and Health Care,Infection Control,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China;不详)

机构地区：[1]湖北医药学院附属太和医院防保感控处,湖北十堰442000 [2]湖北医药学院附属太和医院感染与免疫性疾病研究所 [3]湖北医药学院附属太和医院院务办公室

出　　处：《医学动物防制》2025年第3期281-284,290,共5页Journal of Medical Pest Control

基　　金：国家自然科学基金青年项目(32200156);国家卫生健康委医院管理研究所2022年医疗质量循证管理持续改进研究重点项目(YLZLXZ22K008);白求恩公益基金会资助项目(BCF-XC-SQ-20221206-05)。

摘　　要：目的通过探索实施基于系统管理理论的多院区医院手术部位感染防控管理同质化措施,为多院区医院发展提供有效应对院感同质化管理难题的解决方案。方法自2022年起,运用系统管理理论,构建并全面实施系统性同质化手术部位感染防控措施,包括组织架构、指标监测、风险管理、培训赋能、支持保障和质量管理。通过杏林院感系统收集手术部位感染率,并与干预前的2020和2021年监测数据进行比较,验证综合干预措施的实施效果;采用SPSS 23.0软件处理数据,计数资料采用χ^(2)检验。结果通过感染监测评价防控效果,2020—2023年多院区患者手术部位感染率分别为0.19%、0.16%、0.19%和0.18%,呈现波动状态,差异无统计学意义(χ^(2)=1.58,P=0.063);1个院区患者手术部位感染率呈下降趋势,差异有统计学意义(χ^(2)=7.76,P=0.019);2020—2023年Ⅰ类切口感染率分别为0.16%、0.20%、0.09%和0.08%,呈下降趋势,差异有统计学意义(χ^(2)=19.44,P<0.001)。结论通过在多院区实践基于系统管理理论构建的术后感染防控系列措施,初步显现出Ⅰ类切口感染率持续降低的良好效果。Objective To provide an effective solution to the problem of homogenous management of nosocomial infection for the development of multi-district hospitals by exploring and implementing the measures of homogenous management of surgical site infection prevention and control based on system management theory in multi-district hospitals.Methods Since 2022,systematic and homogenous measures for the prevention and control of surgical site infections,including organizational structure,indicator monitoring,risk management,training and empowerment,support and assurance,and quality management,were established and comprehensively implemented by applying systematic management theory.The rate of surgical site infections was collected through the xinglin hospital infection system and compared with the pre-intervention monitoring data of 2020 and 2021 monitoring data to validate the effect of the implementation of the comprehensive intervention measures.SPSS 23.0 software was used to process the data,and the counting data was analyzed byχ^(2)test.Results Evaluate the effectiveness of prevention and control through infection monitoring,the rates of surgical site infections among patients in multiple districts of the hospitals from 2020 to 2023 were 0.19%,0.16%,0.19%,and 0.18%,respectively,showing fluctuations,and the difference was not statistically significant(χ^(2)=1.58,P=0.063),while the rate of surgical site infections among patients in one district of the hospital showed a downward trend,and the difference was statistically significant(χ^(2)=7.76,P=0.019).The rates of class I incision infections from 2020 to 2023 were 0.16%,0.20%,0.09%,and 0.08%,respectively,showing a downward trend with a statistically significant difference(χ^(2)=19.44,P<0.001).Conclusion By practicing postoperative infection prevention and control measures constructed on the basis of systems management theory in multiple hospital districts,the initial good result shows that a continuous reduction in the rate of class I incision infections.

关 键 词：多院区医院 医院感染 手术部位感染 干预 监测 系统管理理论 

分 类 号：R197.3[医药卫生—卫生事业管理]