对我国医院感染管理现状及发展趋势分析

An analysis on current situation and development tendency of hospital infection management in China

目的 掌握我国医院感染管理现状,探讨其发展趋势。方法 采用问卷形式对北京、上 海、广州三城市不同级别的16家医院进行医院感染管理基本情况的调查,并与1994及1999年两次全 国调查中的相关结果进行比较,同时对手部卫生执行情况进行现场观察评估。结果 我国大中型医院 的感染管理体系已日趋完善,在专业科室职能建设、专职人员队伍层次及水平等方面已达到较高水平, 但仍存在许多问题;医护人员在接触病人后洗手率达60％,明显高于接触病人前及接触物品后35％的 手卫生执行率。结论 我国医院感染管理专业正处在飞速发展的关键时期,已有相当的积累和较为扎 实的基础,但在发展方向上应全面引进质量管理的技术指标,尝试由结果评价为主的管理向过程管理转 变,并突出循证医学在管理上的指导作用,用系统的观点推动医院感染管理与医疗过程的良性互动。

Objective To understand the current situation of hospital infection management in some hospitals in China and explore its development tendency. Methods Surveys were made by means of questionnaires on hospital infection management in 16 hospitals of various tiers in Beijing, Shanghai and Guangzhou and the results were compared with those of the two nation-wide surveys conducted respectively in 1994 and 1999. At the same time a dynamic assessment was made of hand hygiene implementation. Results The infection management systems in large and medium-sized hospitals in China were becoming increasingly perfect and a fairly high level was reached in function construction, team structure and expertise of hospital infection management departments. However, there were still many problems. 60% of medical staff washed their hands after patient-contact while only 35% did so before patient-contact and after item contact. Conclusion Hospital infection management in China has reached an important stage of accelerated development with substantial accumula- tion and more solid foundation. However, as far as development tendency is concerned, we should introduce technical indexes for quality control, put more emphasis on process-evaluation rather than result-evaluation in quality control management, stress the guiding role of evidence-based medicine in hospital management and promote a benign interaction between the hospital infection management and medical treatment process.