医院门诊部预防感染的管理措施

Control of infections in hospital outpatient department

目的分析医院门诊发生感染的主要因素,根据分析结果进行预防感染措施,以降低门诊感染发生。方法2010年2月-2012年5月3036例患者的感染情况进行调查,了解门诊的感染状况,将可能导致感染发生的因素进行非条件logistic回归分析,以确定感染危险因素。结果共调查门诊患者3036例,其中发生医院感染334例,感染率为11.00%;医院感染部位以呼吸道感染为主,占31.14%;其次为胃肠道感染20.96%和泌尿系统感染16.77%;多因素logistic回归分析的结果显示,年龄(β=0.95,OR=2.64)、抗菌药物预防性应用(β=1.82,OR=5.48)、糖尿病史(β=2.11,OR=6.97)、吞咽困难(β=1.90,OR=5.82)、侵入性操作(β=3.78,OR=28.04)等因素与医院感染的发生有着密切关系。结论医院需实施加强处方审查、规范侵入性操作、预防交叉感染、制定卫生管理及消毒制度、建立并完善感染报告制度等管理措施,以减少门诊医院感染发生。

OBJECTIVE To analyze the main factors for the infections in hospital outpatient department and explore the corresponding prevention measures so as to reduce the incidence of infections.METHODS A total of 3036cases of patients who were treated in the hospital from Feb 2010to May 2012were investigated,then the non-conditional logistic regression analysis of the risk factors for the infections was performed so as to determine the risk factors.RESULTS Totally 3036cases of outpatients investigated,the nosocomial infections occurred in 334casetime of patients,among which 31.14% were with respiratory tract infections,20.96% were with gastrointestinal tract infections,and 16.77% were with urinary tract infections.The multivariate logistic regression analysis showed that the age（β=0.95,OR=2.64）,the prophylactic use of antibiotics（β=1.82,OR=5.48）,the history of diabetes（β=2.11,OR=6.97）,dysphagia（β=1.90,OR=5.82）,and invasive operation（β=3.78,OR= 28.04）were closely related to the incidence of nosocomial infections.CONCLUSIONIt is necessary for the hospital to strengthen the review of prescription,standardize the invasive operation,prevent the cross infections,formulate the health management and disinfection system,and establish the infection report system so as to reduce the incidence of nosocomial infections in the outpatient department.