感染性疾病门诊建设现状调查分析

Analysis of cross-sectional investigation about the clinic administration of infectious disease

目的了解感染性疾病科建设、运行状况,提出改进建议。方法调查二级以上医疗机构32所,其中二级以上综合医院及综合性专科医院27所,单纯性专科医院5所。调查的内容为门诊预检分诊,感染性疾病科建筑区域布局及病人就医流程,日常工作运行情况,医务人员的相关消毒隔离、疾病知识等。结果27所二、三级医疗机构中,设有预检分诊台、分诊标志的23所,占85.1%;预检分诊处配备了防护用品,对传染病分诊病员进行登记的10所,占37%;建筑区域布局、就诊流程基本合格的6所,占22.2%;对传染病相关预检分诊和消毒隔离基础知识提问,回答基本准确的15所,占55.5%:27所医疗机构中感染性疾病门诊仅能在白天正常运转的2所,占7.4%;5所专科医疗机构,2所按要求设置了传染病分诊点。公布了转诊医院,配备了相关用品,占40%。结论感染性疾病科的建设和管理仍不到位,与标准要求有较大差距。各地区政府应在财政上定向给与扶持,卫生行政部门应制定具体的、切实可行的实施办法,推动和指导医疗机构的工作。医疗机构应重视感染性疾病科的建设与管理,完善相关制度、流程,加强对医务人员感染性疾病相关知识的培训和考核,使感染性疾病科能真正运行起来,为应对传染病的暴发流行打下良好的基础,降低院内感染的发生。

Objective To understand the administration of infectious disease department, operating status and propose the improvement suggestions. Method 32 medical institutions grade Ⅱ and above were investigated, 27 of them were general hospitals and general specialty hospitals, 5 of them were pure specialty hospitals. The investigation include ： clinic previewed triage, layout of infectious disease construction, flowsheet of receiving treatment, the daily operating status and the related knowledge of disinfection and isolation. Results Among 27 medical institutions grade Ⅱ and Ⅲ , 23 （ 85.1% ） had triage desk and obvious notation; 10（ 37% ）had preventive articles perpared in perviewd triage area and had the patients with infectious disease registered. 6（ 22.2% ）had merely qualified construction layout and flowsheet of receiving treatment. Fifteen（ 55.5% ）hospitals had the correct answers to the questions about the basic previewd triage knowledge of related infectious disease, basic knowledge of disinfection and isolation. Two （7.4%） of 27 medical institutions had their clinics of infectious disease operated normally during daytime only. Among 5 investigated medical institutions, 2 （40%）had infectious disease triage area installed at request, transferred hospital announced and had related articles prepared. Conclusions The construction and administration of infectious disease department were not in order, there was big difference compared to the standard. The district government should increase financial support. The health bureau should formulate plan which is concrete and feasible to push about and direct the medical institutions working better. Medical institutions also should put more attention to administration of infectious disease department, perfat related system and flowsheet, intensify the training and test of medical staff about infectious disease knowledge in order to make the infectious disease department operated effectively, lay solid foundation for coping with the fulminate epidemic of infectious disease and decrease the incidence of nosocomial infection.