福建省41所医院血液透析室医院感染管理现状分析

Analysis the status of the nosocomial infection management in hemodialysis sections of 41 hospitals in Fujian province

目的了解福建省血液透析室的医院感染管理现状，以督促其持续改进，实现规范化管理。方法调查二级以上医院具备3台以上（含3台）透析机且独立开展工作的血液透析室共计41所，采取现场调查与环境微生物学监测相结合。结果医院的等级越高，医院感染管理各项措施的落实情况越好。二级医院及民营医院规章制度不达标者占同一级别调查医院的56．2％；布局流程不达标者占75％；三级乙等及以下医院的透析器复用管理及消毒灭菌存在较多缺陷；各级医院的手卫生设施及人员依从性不达标者占55％以上。各级医院环境微生物学监测结果，透析用水的合格率达90％以上，透析液合格率78．6％～86．2％，手消毒合格率56．6％～78．6％。结论加强对二级医院及民营医院的监管以及各级医院血透室人员手卫生和医院感染相关知识的培训，督促调查中医院感染管理较差的医院针对具体问题进行整改。

Objective To find out the status of nosocomial infection management in hemodialysis sections, in order to encourage their continuous quality improvement and standardize their management. Methods 41 hemodialysis sections with 〉 3 dialyzers and independent operation were chosen for investigation. On-site investigation and environmental microbiology monitoring combined. Results The higher the level of the hospital, the better the nosocomial infection control in its implementation of the infection control measures. In terms of rules and regulations, incompliant secondary hospitals and private hospitals accounted for 56.2% of hospitals of the same ranking; in terms of layout and processes, 75% are found incompliant; and various defects are found in the dialyzer reuse management and disinfection in tertiary and lower hospitals. As to hand hygiene of the staff, the incompliance rate is over 55%. As indicated in the results of microbial environment monitoring, the compliance rate of dialysis water is over 90%, that of dialysate is 78.6% - 86.2%, and that of hand disinfection is 56.6% - 78. 6%. Conclusion It is imperative to strengthen the supervision of secondary hospitals and private hospitals, and to train their staff in the knowledge of hand hygiene and nosocomial infection in hemodialysis rooms. Hospitals found with poor infection management will be encouraged to take issue-specific actions for rectification,