医院感染实时监控系统的开发与应用

Development and application of real-time surveillance system for nosocomial infection

目的解决医院感染在线、实时监测问题,实现感染病例智能化识别与预警,并进行实时干预-反馈,提高监测效率,全面提升预防控制水平。方法依据《医院感染监测规范》和《医院感染诊断标准》等标准,结合实际工作经验,借鉴国内外监测系统的优点,利用计算机网络技术,设计并开发医院感染实时监控系统(RT-NISS)。结果 RT-NISS通过数据访问中间件技术,采集医院信息管理系统(HIS)、实验室信息管理系统(LIS)、电子病历管理系统(EMR)等相关数据,建立起动态的感染信息基础数据库,实现了对患者从入院到出院全过程在线监测;通过嵌入专业筛查策略,实现了疑似感染病例智能识别,并进行个案预警,方便专职人员判别;通过建立交互平台,实现了感染病例实时推送、精确诊断、干预与反馈,使专职人员与临床医师共同参与感染诊断与预防控制;通过建立暴发预警机制,实现了暴发隐患的及时发现;通过规范的监测流程和计算方法,进行全院综合性监测和目标性监测,并实现了全面、准确统计分析结果的输出;通过先进的计算机技术,实现了系统的可操作性、高效性、安全性和开放性。结论 RT-NISS是高效率的医院感染监测与预防控制系统,通过准确、高效的预警机制和临床干预-反馈机制,实现了感染全过程监测和感染预防控制"关口前移",开创了医院感染监测与预防控制工作新模式。

OBJECTIVE To solve the problem of on-line, real-time and automated monitoring nosocomial infection, and to raise the overall level of nosocomial infection surveillance, prevention and control. METHODS According to nosocomial infection surveillance standards, .summing up the practical work experience, and learning the advantages of existing nosocomial infection surveillance systems, then the real-time nosocomial infection surveillance system（RT-NISS）was designed by advanced computer network technology. RESULTS RT-NISS data accessed through LAN and middleware technology, gathered nosocomial infection data from HIS, LIS, EMR sys- tems. The system created dynamic infection information database to achieve on-line monitoring the patient of the whole process from admission to discharge. The infection control professionals and clinicians could determine and confirm suspected cases by embedded professional screening strategy of early-warning intelligence. The system es- tablished interactive-platform to achieve a precise diagnosis, real-time online communication and enabling clinicians to actively participate in anti-infection control. The system could detect the early outbreaks of nosocomial infection risks through the establishment of early warning mechanisms. It could output the accurate statistical analysis of comprehensive hospital-wide monitoring and targeted monitoring through standardized monitoring processes and methods of calculation. The system had a good feature of operability, efficiency, security and friendly interface through the application of advanced of information technology. CONCLUSION RT-NISS is a effective tool of infec- tion surveillance, prevention and control. And it provides accurate and efficient early warning mechanisms and clinical intervention-a feedback mechanism. To some extent, this could be called a new kind modelof prevention and control of nosocomiaI infection surveillance and management, which is an important part of a digital hospital management. In practical the RT NISS need continuous improvement and perfection.