两种方法调查医院感染现患率结果比较与分析

Investigation of prevalence rate of nosocomial infection by two methods

目的综合评价采用床旁调查+查阅病历相结合的方法(手工调查)与利用医院感染实时监控系统调取数据的方法(RT-NISS调查)进行医院感染现患率调查的效果,为改进现患率调查方法提供参考依据。方法运用横断面调查的方法,选取2014年11月26日1 657例住院患者为研究对象,分别采用手工调查和RT-NISS调查方法进行调查,由医院感染专职人员利用Excel软件对调查数据进行整理汇总,并采用SPSS13.0统计软件进行分析。结果共调查住院患者1 657例,实际发生医院感染70例,医院感染现患率为4.22%;手工调查医院感染现患率为3.98%,RT-NISS调查医院感染现患率为4.34%,两种方法所得结果差异无统计学意义;手工调查和RT-NISS调查所得结果与调查当日实际医院感染一致性均较好,其Kappa值分别为0.816、0.853,差异有统计学意义;RT-NISS调查方法的灵敏度、总符合率、Youden指数和比数积均高于手工调查方法,漏诊率低于手工调查方法;而特异度和误诊率与手工调查方法近似。结论 RT-NISS调查方法效率高、准确性好,有利于提高医院感染监测水平。

OBJECTIVE To comprehensively evaluate the effect of investigation of prevalence rate of nosocomial infection by using the bedside investigation plus review of medial records（manual survey）and the real-time nosocomial infection surveillance system（RT-NISS surgery）for retrieval of data so as to provide guidance for improvement of investigation method of the prevalence rate.METHODS By means of cross-sectional survey,a total of 1 657 patients who were hospitalized on Nov 26,2014 were recruited as the study objects and were investigated by respectively using the manual survey method and the RI-NISS survey method.The professional infection control staff cleared up and processed the survey data by using the Excel software,and the statistical analysis was performed by using SPSS13.0software.RESULTS Of totally 1 657 hospitalized patients who were included in the survey,70 patients had the nosocomial infection,with the prevalence rate of 4.22%;the prevalence rate of nosocomial infection was 3.98% by the manual survey method,4.34% by the RT-NISS survey method,and there was no statistically significant difference between the two survey methods.The survey results of both the manual survey method and the RT-NISS survey method were highly consistent with the actual prevalence rate of nosocomial infection on the survey day,and the Kappa values were 0.816 and 0.853,respectively,with significant difference.The sensitivity,total coincidence rate,Youden index,and odds product of the RT-NISS survey method were higher than those of the manual survey method,while the rate of missed diagnosis of the RT-NISS survey method was lower than that of the manual survey method;the RT-NISS survey method was similar to the manual survey method in the specificity and misdiagnosis rate.CONCLUSION The RT-NISS survey is highly efficient and accurate and is conducive to the improvement of surveillance of the nosocomial infection.