医院感染暴发演练方法初探及经验分析

Evaluation on drill method to prepare for healthcare-associated infection outbreak

目的探讨医院感染暴发演练的方法,加强对医院感染暴发的控制。方法某院2014年1月16日神经外科上报2例手术部位感染(SSI)病例,针对此事启动了医院感染暴发应急演练,对2012年1月—2014年1月神经外科的SSI病例进行分析,SSI相关的手术间和神经外科监护室(NSICU)空气、物体表面、医护人员手等进行采样分析。结果神经外科2013年7月份发生了3例SSI(其中1例为疑似病例,未做脑脊液培养),其他月份均未超过2例,不能确认为SSI暴发。相关手术间空气、物体表面及工作人员手共采集标本16份,微生物检测均合格。NSICU环境、物体表面及工作人员手共采集标本13份,合格率为61.54%;其中2份空气标本细菌数均超标,且有霉菌生长。神经外科手术一次性物品共采样24份,3份为阳性,后复查均合格。结论通过此次医院感染暴发演练,有助于医院感染专职人员更好地掌握医院感染暴发调查方法,提高外科医生及手术护士外科洗手的正确性,强化手术操作规程,保障患者安全。

Objective To evaluate the drill method to prepare for healthcare-associated infection （HAI）outbreak, and strengthen the control of HAI outbreak.Methods According to two cases of surgical site infection （SSI）re-ported by a neurosurgical department on January 16,2014,HAI outbreak emergency drill was started,SSI occurred from January 2012 to January 2014 were analyzed,specimens of air,object surface and hands of health care workers （HCWs）in the SSI-related operating room and neurosurgical intensive care unit（NSICU）were taken and analyzed. Results In July 2013,3 cases of SSI occurred in neurosurgical department （1 case was suspected of SSI,and didn’t perform cerebrospinal fluid culture）,SSI didn’t exceed 2 cases in the other months,and SSI outbreak couldn’t be confirmed. 16 specimens of air,object surface and hands of HCWs in operating room were taken,microbial detection results were all qualified.13 specimens of air,object surface and hands of HCWs in NSICU were taken,qualified rate was 61.54%;and mould was detected from 2 air specimens.24 disposable objects of neurosurgical department were performed bacterial culture,3 were positive,and all were qualified after repeated detection.Conclusion HAI outbreak drill is helpful for HAI management professional personnel to grasp the method of HAI outbreak investigation method,improve the correct hand washing of surgeons and nurses,strengthen the standard operating procedure,and ensure the safety of patients.