湖南省医院感染重点部位预防与控制措施调查分析

Prevention and control of nosocomial infections of key sites in Hunan province

目的通过对湖南省医院感染重点部位预防与控制措施实施的调查,反映其现状,并通过前后对比分析反馈促进各医院改进医院感染预防相关措施。方法自制调查表,通过网上办公系统发放到各医院,并由医院感染专职人员完成调查。结果共调查252所医院,纳入前后对比分析60所;术后各医院手术部位重点预防控制措施的达标率均有不同程度提高(P<0.05):术前30～60min内预防性使用抗菌药物由50.09%上升至61.73%,术后24h内停止预防性使用抗菌药物由4.49%上升至17.15%,换药遵守无菌操作由84.22%上升至92.40%,外科医师手消毒步骤合格率由86.49%上升至93.53%,手术备皮方式采用刮除毛发的方式由97.27%下降至69.00%;糖尿病患者术中血糖的控制、手术过程保温控制措施的构成及术后手术切口标本送检、手术部位皮肤消毒方式、静脉置管位置构成,前后调查比较差异无统计学意义。结论多次调查对比分析反馈是提高医院感染预防与控制措施的良好方法。

OBJECTIVE To reflect the actual situation of prevention and control measures for key sites of nosocomial infections in Hunan province and to put forward the relevant prevention measures through the information analysis and feedbacks.METHODS Self-designed questionnaires were assigned to the targeted hospitals via online office system and were filled out by the professional staff for control of nosocomial infections.RESULTS Totally 252 hospitals were involved in the study and 60 of them were included into staged comparative analysis.The staged comparative analysis of survey results showed that performances of prevention and control measures on key sites for every hospital have been improved in varying degrees（P0.05）： preventative usage of antibacterial medicines within 30 to 60 minutes before the operation increased from 50.09% to 61.73%,the utilization rate of prophylactic antibiotics being withdrawn within 24 hours increased from 4.49% to 17.15%,the drug dressing following the aseptic operation increased from 84.22% to 92.40%,the qualified rate of hand sterilization procedures for surgeons increased from 86.49% to 93.53%,and the use rate of hair shaving for skin preparation decreased from 97.27% to 69.00%.However,as compared with the blood glucose control for the diabetes patients,composition of heat preservation measures during the process of operation,the submission of surgical incision specimens after the operation,approaches for skin sterilization of surgical site,and the location of vein catheterization,the differences were not statistically significant.CONCLUSION The frequent survey,comparison,and feedbacks are effective ways to improve the prevention and control measures for nosocomial infections.