外科系统医院感染管理的风险评估研究

Risk assessment study of nosocomial infection management in surgical system

目的为探究外科系统医院感染管理风险,明确医院感染防控重点,有效利用感控资源,实现精细化感控提供临床依据。方法设计风险评估表对2017年1月某三级甲等综合性教学医院外科系统进行风险识别、风险估计及风险评价。结果按照百分位的不同,根据评估分值进行风险等级划分,神经外科为极高风险科室,外科ICU、急诊外科、普外科为高风险科室;不同的科室其风险指标的特点有所不同,耳鼻喉科、肝胆外科和颌面外科管理指标风险高;外科ICU、神经外科和乳腺外科过程指标风险高;神经外科、外科ICU和普外科结果指标风险高。结论客观、科学、循证的风险评估方法,为医院感染管理工作指明方向,找到风险防范重点,提升感控效能。

OBJECTIVE To explore risk of the surgical system nosocomial infection management,clear the focus on prevention and control of nosocomial infections,and effectively use resources of infection control,so as to provide the clinical basis for realization of refined control of nosocomial infections.METHODS In Jan.2017,risk identification,risk estimate and risk assessment of a tertiary first-class comprehensive teaching hospital surgical system were carried out by using risk assessment table.RESULTS According to different percentiles,with the risk level divided based on the assessment scores,neurosurgery had very high risk,and surgical ICU,emergency surgery,and general surgery had high risk.The characteristics of the risk indexes were different among different clinical departments.Otolaryngology,liver and gallbladder surgery and maxillofacial surgery had high risk of management index,surgical ICU,neurosurgery and breast surgery had higher risk of process index,and neurosurgery,surgical ICU,and general surgery have high risk of result index.CONCLUSIONAn objective,scientific and evidence-based risk assessment method can indicate the direction of nosocomial infection management work,find risk prevention focus and improve the efficiency of infection management.