多模态干预对降低血管导管相关感染发病率的效果评价  

Effects evaluation of multimodal interventions on reducing the incidence rate of vessel catheter associated infection

作　　者：刘厚荣 曾金彩 黄雪欢 梁宝方[1] LIU Hourong;ZENG Jincai;HUANG Xuehuan;LIANG Baofang(Office of Hospital Infection Management,the Tenth Affiliated Hospital of Southern Medical University(Dongguan People’s Hospital),Dongguan,Guangdong 523000,P.R.China;Department of Preventive Healtht,the Tenth Affiliated Hospital of Southern Medical University(Dongguan People’s Hospital),Dongguan,Guangdong 523000,P.R.China)

机构地区：[1]南方医科大学第十附属医院(东莞市人民医院)医院感染管理办公室,广东东莞523000 [2]南方医科大学第十附属医院(东莞市人民医院)预防保健科,广东东莞523000

出　　处：《华西医学》2025年第3期377-382,共6页West China Medical Journal

基　　金：东莞市科学技术局社会发展科技项目(20221800902252)。

摘　　要：目的探讨通过多模态干预提高核心防控措施执行率后,对降低血管导管相关感染(vessel catheter associated infection,VCAI)发病率的效果。方法选取2021年1月—2022年12月东莞市人民医院5个血管导管置管率及感染率较高的科室在院并留置血管导管的患者。根据患者在院时间分为干预前组(2021年1月—12月)和干预后组(2022年1月—12月)。比较干预前后的医务人员核心防控措施考核合格率,两组患者的VCAI发病率、置管天数和置管率。结果共纳入患者8174例,其中干预前组3915例,干预后组4259例。干预前组的总住院日数为122885 d、总置管日数为48028 d、VCAI发生28例,干预后组的总住院日数为126966 d、总置管日数为51253 d、VCAI发生12例。干预后,VCAI核心防控措施执行率提升[69.21%(2907/4200)vs.91.24%(3832/4200);χ^(2)=642.090,P<0.001]、医务人员核心防控措施考核合格率提高[53.33%(128/240)vs.91.67%(220/240);χ^(2)=88.443,P<0.001]、血管导管置管率提高[39.08%(48028/122885)vs.40.37%(51253/126966);χ^(2)=42.979,P<0.001]、VCAI发病率降低[0.58‰(28/48028)vs.0.23‰(12/51253);事件发生率比值=0.40,95%置信区间(0.20,0.79),P=0.008]。结论通过多模态干预提高VCAI核心防控措施执行率可提高医务人员核心防控措施考核合格率,有助于降低VCAI发病率,保障患者医疗安全,为VCAI防控提供循证依据。Objective To explore the effect of multimodal interventions in improving the compliance rate of core infection control measures on reducing the incidence rate of vessel catheter associated infection(VCAI).Methods Inpatients with intravascular catheters in 5 departments with high rates of vascular catheterization and infection of Dongguan People’s Hospital between January 2021 and December 2022 were selected.According to the hospital stay,patients were divided into a pre-intervention group(January to December 2021)and a post-intervention group(January to December 2022).The core infection control measures assessment pass rates of medical staff between the two periods and the differences in the incidence rate of VCAI,average catheterization days,and catheterization rate before and after intervention in both groups were compared.Results A total of 8174 patients were included.Among them,there were 3915 patients in the pre-intervention group and 4259 patients in the post-intervention group.In the preintervention group,the total length of hospital stay was 122885 days,the total number of catheterization days was 48028 days,and 28 cases of VCAI occurred.In the post-intervention group,the total length of hospital stay was 126966 days,the total number of catheterization days was 51253 days,and 12 cases of VCAI occurred.After intervention,the compliance rate of VCAI core infection control measures was improved[69.21%(2907/4200)vs.91.24%(3832/4200);χ^(2)=642.090,P<0.001],the pass rate of medical staff’s core infection control measures assessment was improved[53.33%(128/240)vs.91.67%(220/240);χ^(2)=88.443,P<0.001],the catheterization rate was increased[39.08%(48028/122885)vs.40.37%(51253/126966);χ^(2)=42.979,P<0.001],and the incidence rate of VCAI was reduced[0.58‰(28/48028)vs.0.23‰(12/51253);incidence-rate ratios=0.40,95% confidence interval(0.20,0.79),P=0.008].Conclusions Improving the compliance rate of VCAI core infection control measures through multimodal interventions can significantly improve the passing ra

关 键 词：血管导管相关感染 血管导管 多模态干预 发病率 

分 类 号：R47[医药卫生—护理学]