NSICU呼吸道阴沟肠杆菌疑似感染暴发调查分析及护理管理

Analysis and Nursing Management of Suspected Infection Outbreak with Nitrobacteria Cloacae in Neurosurgical Intensive Care Unit

目的探讨NSICU呼吸道阴沟肠杆菌疑似感染暴发的原因,总结防控的有效管理对策。方法通过对某三甲医院NSICU2013年7月一起阴沟肠杆菌疑似感染暴发流行事件进行流行病学调查及环境微生物学检测,明确诊断并进行危险因素分析。结果医务人员感染防控意识淡漠,手卫生依从性差;病房内环境、仪器设备清洁和消毒监管不力是引起此次呼吸道阴沟肠杆菌疑似感染暴发流行的主要原因。结论通过严格隔离患者,加强全员执行洗手的依从性和规范性教育,加强对病房环境、仪器设备、医护人员、护工、保洁人员及探视者的管理,加强医护人员的信息沟通等干预措施,切断内源性和外源性感染传播途径,可控制医院阴沟肠杆菌感染暴发。

Objective To investigate the causes about the suspected infection outbreak with respiratory nitrobacteria cloacae in NSICU, and summarize the effective control measures. Methods By means of epidemiological investigation and environmental microbiological monitoring about the suspected infection outbreak with nitrobacteria cloacae occurred in one three-level hospital in July of 2013, to obtain a definite diagnosis and analyze the risk-factor. Results Weak awareness of prevention and control of infection, poor hand hygiene compliance, insufficient cleaning and sterilization of the inner ward environment and instruments are major causes of the suspected outbreak of the infection. Conclusion Intervening measures such as strict isolation of patients, reinforcing normative education of hand hygiene in whole staffs, strengthening the administration of wards environment, instruments, medical staffs, nursery workers, cleaners and visitors, and increasing communication among the medical staffs are implemented to cut off the endogenous and exogenous routes of transmission, which can prevent the infection outbreak with nitrobacteria cloacae effectively in hospital.