网式监管对医院多药耐药菌感染的预防控制效果研究

Effect of net style supervision on control and prevention of nosocomial infections due to multidrug-resistant bacteria

目的探究网式监管对医院多药耐药菌感染的预防控制效果。方法选取2010年6月-2014年7月于重症监护病房(ICU)就诊且使用≥3类的抗菌药物治疗的1 000例重症患者作为研究对象,将2010年6月-2012年6月的511例患者作为对照组,2012年7月-2014年7月的489例作为观察组,对照组采取传统常规的管理模式进行干预,观察组采取网式监管控制手段进行干预,对比两组患者多药耐药菌感染率,以及在医院感染、执行预防措施与控制措施等方面的改善程度,分析网式监管对医院多药耐药菌感染的预防控制效果。结果对照组患者中多药耐药菌感染率为38.55%,显著高于观察组21.06%;观察组患者在正确使用防护用品、用物专用、设置隔离标示及开具隔离医嘱的执行率分别为93.25%、86.30%、88.34%、91.00%,明显高于对照组的23.87%、34.44%、26.81%、31.51%,差异有统计学意义(P<0.05);观察组患者在健康宣教、医用废物的处理和用物处理与对照组相比具有明显提高,差异有统计学意义(P<0.05)。结论采取网式监管对医院多药耐药菌感染的预防控制效果显著,有利于降低医院感染率,便于感染患者早发现、早隔离、早治疗。

OBJECTIVE To explore the effect of net style supervision on control and prevention of nosocomial infec‐tions due to multidrug‐resistant bacteria .METHODS A total of 1 000 critically ill patients who were treated in the intensive care unit （ICU） and used no less than 3 types of antibiotics from Jun 2010 to Jul 2014 were recruited as the study objects ,511 patients who were treated from Jun 2010 to Jun 2012 were assigned as the control group , and 489 patients who were treated from Jul 2012 to Jul 2014 were set as the observation group .The control group was treated with conventional management mode for intervention ,while the observation group was given the net style supervision for intervention .The incidence of multidrug‐resistant bacteria infections and the improvement of control and prevention of nosocomial infection were compared between the two groups ,and the effect of the net style supervision on control and prevention of the multidrug‐resistant bacteria infections was observed .RESULTS The incidence of multidrug‐resistant bacteria infections was 38 .55% in the control group ,significantly higher than 21 .06% in the observation group .The implementation rates of proper use of protective equipments ,use of materi‐als dedicated ,setting the isolation quarantine prescription label ,and issuing the quarantine prescription of the ob‐servation group were respectively 93 .25% ,86 .30% ,88 .34% ,and 91 .00% ,significantly higher than 23 .87% , 34 .44% ,26 .81% ,and 31 .51% of the control group （P〈0 .05） .As compared with the control group ,the health education ,disposal of medical waste ,and disposal of used items of the observation group were significantly im‐proved （P〈0 .05） .CONCLUSIONS The net style supervision can achieve significant effect on control and preven‐tion of the multidrug‐resistant bacteria infections and reduce the incidence of nosocomial infections ,and it is condu‐cive to the early discovery ,isolation ,and treatment of the patients with infections .