营利性与非营利性社区卫生服务站的医院感染管理效果比较

Comparison of effects of control of nosocomial infections between profit and nonprofit community health centers

目的对营利性与非营利性管理模式下社区卫生服务站的医院感染管理效果进行比较,以探索社区卫生服务站的医院感染管理模式,以提高管理质量。方法自2005年1月-2012年6月在中山市小榄镇社区卫生服务站的非营利化过程中,根据医院感染管理要求制定质量评价表,对辖区内14所社区卫生服务站进行评价;对其在营利性和非营利性管理模式下的医院感染管理达标率、医务人员无菌操作、无菌物品使用和管理、手卫生管理、职业防护和消毒液的使用、医疗废物管理、环境卫生质量等项目的达标率进行统计对比。结果 14所营利性社区卫生服务站的医院感染管理检查次数为220次,其中达标20次,达标率为9.09%;转为非营利性管理模式后,检查次数为228次,其中达标218次,达标率为95.61%,两者差异有统计学意义(P<0.01);非营利性社区卫生服务站在医务人员的无菌操作、无菌物品使用和管理、手卫生管理、职业防护和消毒液的使用、医疗废物管理、环境卫生质量等项目的达标率均高于营利性管理模式,差异有统计学意义(P<0.01)。结论非营利性管理模式有利于提高社区卫生服务站的医院感染管理质量。

OBJECTIVE To evaluate the effects of the control of nosocomial infections in the community health centers under the profit and nonprofit modes so as to explore the modes of nosocomial infection control and improve the quality management. METHODS From Jan 2005 to Jun 2012, in the nonprofit innovation process of community health centers in Xiaolan, Zhongshan, 14 community health centers in this area were evaluated periodi- cally by a measuring scale made according to nosocomial control requirements. The compliance rate of nosocomial infection control, compliance rate of aseptic techniques , use and management of sterile items, hand hygiene man- agement, occupational protection and disinfectant use , medical waste management, and sanitation were compared statistically between the profit management mode and nonprofit mode. RESULTS Of 220 times of examination of nosocomial infections in the 14 community health centers, there were 20 times that met the standard with the com- pliance rate of 9.09 %. However, after the transformation to nonprofit management mode, there were 228 times of examination, among which there were 218 times that met the standard with the compliance rate of 95.61%, the difference was significant（P〈0.01）. The compliance rates of the aseptic operation, use and managent of sterile items, hand hygiene management, occupational protection, use of disinfectants, medical waste management, and environmental sanitation were higher under the nonprofit mode than under the profit mode, the difference was sta- tistically significant（P〈0.01）. CONCLUSION The nonprofit management mode helps to improve the quality of nosocomial infection control in the community health center.