上海市医疗机构医院感染管理难点调研分析  

Investigation and analysis of difficulties in nosocomial infection management in medical institutions of Shanghai

作　　者：郭家宁 高晓东[2] 史庆丰[2] 王燕婷 张鶤 GUO Jianing;GAO Xiaodong;SHI Qingfeng;WANG Yanting;ZHANG Kun(Quality Management Department,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China;Department of Hospital Infection Management,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,P.R.China;Nursing Department,Shanghai Skin Disease Hospital,Shanghai 200443,P.R.China;Shanghai Hospital Association,Shanghai 200040,P.R.China)

机构地区：[1]郑州大学第三附属医院质量管理部,郑州450052 [2]复旦大学附属中山医院医院感染管理科,上海200032 [3]上海市皮肤病医院护理部,上海200443 [4]上海市医院协会,上海200040

出　　处：《华西医学》2025年第3期406-411,共6页West China Medical Journal

基　　金：上海市卫生健康委员会卫生健康政策研究项目(2023HP81);“感·动中国”医疗机构感染预防与控制科研项目(GY2023011);上海市疾病预防控制局政策研究课题(2024JZ34);上海申康医院发展中心管理研究项目(2022SKMR-05,2022SKMR-16)。

摘　　要：目的调查和分析上海市不同级别医疗机构医院感染(院感)管理难点,为进一步提高院感管理水平提供科学依据。方法设计包含职称晋升、待遇、人员配备等10个院感管理难点的调查问卷,2023年10月由上海市院内感染质量控制中心联合上海市医院协会对上海市各医疗机构的院感管理科负责人进行专项问卷调查,并根据医院级别、专职人员配备及变动情况对难点得分进行分层分析。结果共发放问卷548份,回收合格问卷530份,回收率为96.72%。其中,公立三级医疗机构55所、公立二级医疗机构93所、公立一级医疗机构169所、社会办医疗机构213所,其院感专职人员配备达标率分别为76.36%(42/55)、72.04%(67/93)、31.95%(54/169)、21.60%(46/213)。不同级别医疗机构的院感专职人员配备达标率比较,差异有统计学意义(χ^(2)=105.149,P<0.001)。不同级别医疗机构的院感管理难点总得分比较,差异无统计学意义(F=1.657,P=0.176);但不同级别医疗机构在职称晋升困难、日常规范和要求繁琐、专职人员配备不足和人员流动较大的得分比较,差异均有统计学意义(P<0.05)。结论职称晋升困难、日常规范和要求繁琐、专职人员配备不足及经验不足是上海市各级医疗机构医院管理主要的难点,今后各医疗机构应加强专职人员配备并提升专职人员能力,提供畅通的晋升途径,最终促进院感管理的高质量发展。Objective To investigate and analyze the difficulties of nosocomial infection management in different-level medical institutions in Shanghai,and to provide scientific basis for improving the level of nosocomial infection management.Methods A questionnaire was designed to include 10 difficulties in nosocomial infection management such as professional title promotion,salary,and personnel allocation.In October 2023,the Shanghai Nosocomial Infection Quality Control Center,in collaboration with the Shanghai Hospital Association,conducted a questionnaire survey among the heads of nosocomial infection management departments in medical institutions in Shanghai.The scores of difficulties were analyzed by stratification according to hospital level,allocation and changes of full-time personnel.Results A total of 548 questionnaires were distributed,and 530 valid questionnaires were retrieved,with a recovery rate of 96.72%.There were 55 public tertiary,93 public secondary,169 public primary and 213 social medical institutions.The rates of full-time personnel allocation meeting standards were 76.36%(42/55),72.04%(67/93),31.95%(54/169),and 21.60%(46/213),respectively.There was a statistically significant difference in the rates of full-time personnel allocation meeting standards among different levels of medical institutions(χ^(2)=105.149,P<0.001).There was no statistical difference in the total scores of nosocomial infection management difficulties among different-level medical institutions(F=1.657,P=0.176).There were statistically significant differences in the scores of difficulties in professional title promotion,cumbersome daily norms and requirements,insufficient allocation of full-time personnel,and high personnel turnover(P<0.05).Conclusions The main difficulties in nosocomial management of medical institutions at all levels in Shanghai include the difficulty in career promotion,cumbersome daily norms and requirements,insufficient allocation of full-time personnel and lack of experience.In the future,medical institutio

关 键 词：医疗机构 医院感染管理 难点 职称晋升 医院感染专职人员 

分 类 号：R47[医药卫生—护理学]