血液科病房施行无陪护管理降低医院感染的探讨

Management without accompanying caregivers in reducing nosocomial infections in hematology ward

目的对比研究血液科病房开展优质护理无陪护管理前后住院患者医院感染的发生率及其相关因素,探讨血液科病房规范化护理管理模式。方法将实施无陪护管理前后的住院患者分成陪护组及无陪护组,对实施管理前后两组患者医院感染发生率、感染部位及感染程度进行比较分析。结果无陪护组发生医院感染52例,医院感染发生率8.71%;陪护组共发生医院感染76例,医院感染发生率12.75%,两者相比差异有统计学意义(χ2=5.09,P<0.05);感染部位两者均以呼吸道居首,占各类感染的50.00%,其他部位依次为胃肠道、口腔及肛周等,而实施无陪护管理后呼吸道感染率从59.21%降至36.54%(χ2=6.35,P<0.05);实施无陪护管理后死亡率从7.89%降至1.92%(χ2=2.13,P>0.05)。结论血液科施行无陪护管理能够明显降低血液科患者医院感染的发生率及感染死亡率,同时降低呼吸道感染的发生率,提高血液科住院患者的安全性,值得推广应用。

OBJECTIVE To contrast and study the prevalence and related factors for nosocomial infections（NI） before and after the implementation of quality of nursing care without accompanying caregivers so as to explore a standard nursing management mode for hematology unit.METHODS The hospitalized patients were divided into the accompanying caregiver group and the non-accompanying caregiver group,then the incidence of nosocomial infections,the infection sites,and the extent of infections were compared and analyzed.RESULTS There were 52 patients with nosocomial infections with the incidence of 8.71% in the non-accompanying caregiver group;there were 76 patients with nosocomial infections with the incidence of 12.75 in the accompanying caregiver groups,the difference was statistically significant（χ2=5.09,P0.05）;respiratory tract was the top infection site,accounting for 50.00%,followed by oral cavity and crissum;the incidence rate of respiratory tract infections decreased from 59.21% to 36.54% after the implementation of accompanying without caregivers（χ2=6.35,P0.05）,the mortality decreasing from 7.89% to 1.92%（χ2=2.13,P0.05）.CONCLUSION The implementation of the accompanying without caregivers can significantly reduce the incidence of nosocomial infections and the mortality in the hematology unit as well as the incidence of respiratory tract infections and can improve the safety of the hospitalized patients,which is worth widely promoting.