风险评估在传染病医院外科医院感染控制中的应用

Application of risk assessment in nosocomial infection control in surgical departments of infectious disease hospitals

目的探讨风险评估在传染病医院外科医院感染控制中的应用,为针对性制定防控措施提供依据。方法 2016年7月上旬采用头脑风暴法对传染病医院外科医院感染风险进行识别,参考《美国华盛顿国家儿童医疗中心流行病与感染控制风险评估与计划》,采用矩阵法进行风险评估,对风险优先级靠前的3个因素进行控制,比较风险评估前后该科室医院感染发生率。结果通过风险评估,该院外科医院感染主要危险因素存在于诊疗过程;经矩阵法评分,排除准备程度高的项目,风险优先级前3位分别是空气传播疾病、血源性感染的防护和空气消毒;开展风险评估和采取针对性措施后,患者医院感染发生率下降到2.03%(χ2=5.480,P=0.019)。结论对传染病医院外科医院感染风险进行评估,能够发现潜在主要风险,降低患者医院感染的发生率,为规范管理和控制医院感染提供依据。

Objective To investigate the application of risk assessment in the control of nosocomial infections in surgical departments of infectious disease hospitals so as to provide references for the regulation of prevention and control measures. Methods Nosocomial infection risks in surgical departments of infectious disease hospitals were identified by the method of brainstorming. Based on risk assessment and planning of American children＇s national medical center in Washington for epidemic and infectious diseases control, the matrix method was used for risk assessment. The three highest risks were controlled, and then we compared the incidence of nosocomial infections before and after the risk assessment. Results The major risk factors in surgical departments existed in the process of diagnosis and treatment. By matrix scoring, excluding high readiness items, we found that the top three risks were airborne diseases, prevention and nursing of hematogenous infections and air disinfection. Nosocomial infection rate in the surgical departments dropped to 2.03% after carrying out risk assessment and taking correspondent measures （X2=5.480, P=0.019）. Conclusion Evaluation of nosocomial infection risk in surgical departments of infectious disease hospitals can discover major potential risks and reduce the incidence of nosocomial infections, which can provide references for management and control of nosocomial infections.