基于网格化管理的持续质量改进筑牢医院感染防控——以南通大学附属医院为例  

Strengthening the Nosocomial Infection Prevention and Control by Continuous Quality Improvement Based on Grid Management Sampled with the Affiliated Hospital of Nantong University

作　　者：顾李琴[1] 肖俊 周小娣[1] 张海峰[1] 陈红[1] 徐晓耘[1] 章艳菊[1] Gu Liqin(Affiliated Hospital of Nantong University,Nantong,P.R.China)

机构地区：[1]南通大学附属医院感染管理办公室,江苏南通226001 [2]南通大学附属医院临床研究中心

出　　处：《中国卫生事业管理》2025年第3期282-285,304,共5页Chinese Health Service Management

基　　金：国家科技部“中枢神经系统感染患者队列特征与体液标记物研究”(2023YFC2306501);江苏省医院协会医院管理创新研究课题“基于风险评估的达芬奇手术围手术期全流程感控管理研究”(JSYGY-3-2024-209)。

摘　　要：目的:探索基于网格化管理的持续质量改进在医院感染管理中的应用效果。方法:选取南通大学附属医院2021年5~12月住院患者为对照组,2022年及2023年同期住院患者分别为观察组1和观察组2,通过描述性分析和χ^(2)检验比较改进前后医院感染率(例次率)、器械相关感染率、多重耐药检出率及感染率、手术监测指标、抗菌药物相关指标、职业暴露及网格员考核成绩等。结果:观察组医院感染率(例次率)、Ⅰ类切口手术预防用药率、与手术相关医院感染率、职业暴露发生率均低于对照组(P<0.05);抗菌药物治疗前病原体送检率、联合用药前送检率及网格员考试成绩均高于对照组(P<0.05)。结论:基于以网格化管理为基础持续质量改进措施可有效提升医院感染管理能力,提高认知行为能力,优化多项感染控制指标及医院感染管理环境。医疗卫生机构可根据自身特点,制定具有自身特色的单元网格医院感染管理模式,以求做到全面分层管理,避免感控死角。Objective To explore the application effect of continuous quality improvement based on grid management in nosocomial infection management.Methods Inpatients in this hospital from May to December 2021 were selected as control group,and the inpatients in the same period in 2022 and 2023 were selected as observation group 1 and observation group 2,respectively.The indexes of infection rate(case rate),device-related infection rate,multiple resistance detection and infection rate,and surgery monitoring indicators,antimicrobial related indicators,occupational exposure and grid member assessment indicators before and after improvement were compared by descriptive analysis andχ^(2) test.Results The nosocomial infection rate(case rate),type I surgical incision surgery preventive medication rate,nosocomial infection rate related to surgery and occupational exposure rate were lower than the control group(P<0.05).While the pathogen detection rate before antimicrobial therapy/key antimicrobial combination therapy and grid test scores were higher than the control group(P<0.05).Conclusion The continuous quality improvement measures based on grid management can effectively improve nosocomial infection management ability,improve their cognitive behavior ability,and optimize a number of infection control indicators and nosocomial infection management environment.According to their own characteristics,medical and health institutions can develop a unit grid hospital infection management mode with their own characteristics,in order to achieve comprehensive hierarchical management and avoid the blind side of infection control.

关 键 词：医院感染 网格化管理 医院质量管理 感染防控 

分 类 号：R197[医药卫生—卫生事业管理]