加强手术室人员管理在预防手术室医院感染中的作用

Effect of strengthening management of operating room staff on prevention of nosocomial infections

目的通过加强手术室人员操作技能及理论观念的管理,观察手术室术后患者并发感染及切口愈合状况,以降低患者术后感染率改善患者预后。方法选取2012年3月-2014年3月于医院行Ⅰ类切口手术患者1 027例,依据2013年3月实施手术室新管理方案干预,将各项检测指标分为干预前及干预后,其中干预前手术患者493例,干预后手术患者534例,分别比较两组患者术后切口感染及愈合率,术前手术室空气等检测状况及保洁人员相关考核结果。结果干预后手术患者术后切口炎症反应11例发生率2.06%,切口感染5例感染率0.94%及切口延迟愈合1例发生率0.19%,均低于干预前,差异有统计学意义(P<0.05);干预后术前检测手术室地面、空气及无影灯表面合格率明显高于干预前,差异有统计学意义(P<0.05);干预后手术室医务人员操作技能考核、无菌观念评分及理论考核成绩均优于干预前,差异有统计学意义(P<0.05)。结论通过实施新的手术室管理方案加强对手术室医务人员工作要求并进行相关的理论技能培训考核,可明显改善手术患者切口愈合,提高手术室各项检测合格率。

OBJECTIVE To strengthen the management of operation skills and theoretical concepts of the operating room staff and observe the prevalence of complicated infections and status of incision healing so as to reduce the in‐cidence of postoperative infections and improve the prognosis .METHODS A total of 1 027 patients who underwent the type I incision surgery from Mar 2012 to Mar 2014 were enrolled in the study and were divided into the pre‐in‐tervention group with 493 cases and the post‐intervention group with 534 cases according to the new interventions to management of operating rooms that were implemented in Mar 2013 .The incidence of postoperative incision in‐fections ,incision healing rates ,status of preoperative examination of air in the operating rooms ,and related as‐sessment results of cleaning staff were observed and compared .RESULTS Totally 11 patients had postoperative in‐cision inflammation after the intervention ,with the incidence rate of 2 .06% ;5 patients had incision infections , with the infection rate of 0 .94% ;1 patient had delayed incision healing with the incidence rate of 0 .19% ;as com‐pared with the pre‐intervention group ,the difference was significant （P〈 0 .05） .The qualified rates of the grounds ,air ,and surfaces of shadowless lamps of the operating rooms were significantly higher after the interven‐tion than before the intervention （P〈0 .05） .The assessment of operation skills ,scores of sterile concepts ,and theoretical assessment results of the health care workers were sigificantly better after the intervention than before the intervention （P〈0 .05） .CONCLUSION It is necessary to strengthen the work requirements of the health care workers through implementation of new programs of management of operating rooms and conduct related trainings and assessments of theories and skills so as to significantly improve the incision healing and raise the qualified rates of the examination items of the operating rooms .