湖南省基层医疗机构医院感染管理现状调查

Status of healthcare-associated infection management in the grassroots medical institutes

目的调查某省基层医疗机构医院感染管理现状。方法采用随机抽样的方法对13个市州的46所基层医疗机构进行现场督察,并填写《基层医疗机构医院感染管理现状调查表》,统计分析相关数据。结果剔除两所公立医院的调查数据,共收集44份合格调查表。44所(100%)医疗机构均由医疗机构主要负责人领导医院感染管理工作。医院感染管理部门设置调查中,设置有独立医院感染管理部门的医疗机构仅2所(4.55%);医院感染管理相关制度与岗位职责的调查中,仅10所(22.73%)医疗机构查阅到制定并规范了调查表中所列的所有14项医院感染管理相关制度与岗位职责,制定百分率最低的为医院感染防控重点部门、关键岗位感染控制职责相关制度的制定(38.64%)。村卫生室工作制度与岗位职责的制定得分低于其他医疗机构(F=5.762,P<0.01);不同医疗机构九项核心制度落实情况的比较中,除"无菌操作"以外的其他项,村卫生室均低于其他医疗机构(均P<0.05)。结论基层医疗机构组织设置、重点部门的医院感染管理、医院感染管理相关核心制度等均未得到落实,其中村卫生室的医院感染管理现状最差,应加大监管力度和加强人员培训。

Objective To investigate the current situation of healthcare-associated infection（HAI）management in grassroots medical institutes in a province.Methods Forty-six grassroots medical institutes in13 cities of the province were selected randomly for the survey,questionnaires about the current situation of HAI management in grassroots medical institutes were filled out,and related data were analyzed.Results Forty-four qualified questionnaires were adopted for analysis,and2 unqualified questionnaires from public hospitals were excluded.HAI management in44 medical institutes（100.00%）was in the charge of major leaders in medical institutes.Only 2institutes（4.55%）set up independent HAI management departments,and 10institutes（22.73%）established basic regulations and position responsibilities of HAI management,38.67% of medical institutes established regulations of HAI prevention and control in key departments and responsibilities for key positions.The score for the establishment of basic regulations and position responsibilities of HAI management in village clinics was lower than the other medical institutes（F=5.762,P〈0.01）.Except aseptic technique,the core regulations of HAI management weren＇t implemented well in village clinics compared with the other institutes（P〈0.05）.Conclusion Organizational settings,HAI management of key departments,and core regulations of HAI management are not performed well in grassroots medical institutes in this province.Village clinics perform the worst in HAI management among all types of grassroots medical institutes.More measures,including education and surveillance,should be taken to improve HAI management in grassroots medical institutes.