九家结核病定点医疗机构结核感染控制现状调查

Tuberculosis infection control survey in nine tuberculosis designated hospitals

目的 了解结核病定点医疗机构结核感染控制情况.方法 采取整群抽样的方法,由同一调查员使用《中国结核感染预防控制手册》中的附表《医疗卫生机构结核感染预防控制监控和评价表》对南昌市所有9家结核病定点医疗机构进行现场观察和关键人物访谈,收集其院内感染制度、预检分诊、健康教育、环境布局、消毒隔离等结核感染预防控制数据.调查结束时由质量控制员进行数据检查并对错、漏项进行补充调查.使用EpiData 3.1软件建立数据库,采用SPSS 15.0软件进行描述性统计学分析.结果 被调查的医疗机构均制定了结核感染控制制度,但均未定期开展结核感染控制监控和评价;有8家机构将门诊确诊和住院确诊的传染性疾病患者与一般患者分开诊治,其中有4家机构将咳嗽患者与其他患者分开;仅3家机构对候诊患者进行健康教育;9家医疗机构的诊室和实验室均通风良好,其中6家医疗机构装有通风设备,但仅3家机构实行定期检测和维护;6家医疗机构在诊室安装了紫外线灯且有常规维护计划,但候诊区、门诊区布局设计均不合理;仅有1家医疗机构为工作人员提供了医用防护口罩,但仅部分工作人员佩戴,医护人员未接受过医用防护口罩的佩戴适合实验测试培训.结论 被调查的医疗机构在结核感染控制方面做了一些工作,但是需要加强结核感染控制的监控与评价,落实好分诊、隔离、布局设计及个人防护等措施,以降低结核感染风险.

Objective To understand the situation of the tuberculosis infection control in TB designated hospitals. Methods The cluster sampling methods was adopted, and a structured questionnaire developed by Chinese CDC was used to collect data about tuberculosis infection in 9 TB designated hospitals in Nanehang city. Site observation and key characters interview was used to collect the infection control data related to within-hospital infection system, and pre check points diagnosis, and health education, and environment layout, and disinfection isolation. Survey data received quality control checks. EpiData 3.1 software was used for setting up database, and SPSS 15.0 software for descriptive statistical analysis. Results All hospitals have developed regulations for tuberculosis infection control but none of them has conducted regular risk monitoring and assessment. Of the 9 hospitals investigated, 8 hospitals isolated patients with infectious disease from the general patients, and patients with cough were isolated in 4 hospitals; Only 3 hospitals provided the health education for the patients; The clinics and laboratories were all well ventilated in 9 hospitals, 6 hospitals were equipped with ventilation equipments and only 3 received regular inspection and maintenance. 6 hospitals installed UV light in the consulting room and there is a regular maintenance plan, but the waiting area, the outpatient service area layout design is not reasonable; There is only one hospital providing medical protective masks to health workers, but only part of the staff wore and none received training courses of the use of masks. Conclusion The hospitals have done some work on infection control, however the monitoring and evaluation still need to be strengthened. The infection control measures, such as triage, isolation and personal protective measures should be well implemented to reduce the TB infection risk.