前馈控制对骨科手术患者消毒供应中心相关医院感染的影响

Influence of feedforward control on central sterile supple department-related nosocomial infections in surgery patients of orthopedics department

目的研究前馈控制对骨科手术患者消毒供应中心相关医院感染的影响,为临床医院感染的控制提供理论依据。方法选择2015年1月-12月住院骨科手术患者1184例作为对照组,另选择2016年1月-12月住院骨科手术患者1204例作为研究组,对照组采用常规方式防控医院感染,研究组在其基础上采用前馈控制,记录院内感染发生情况,对两组患者的住院时间、住院费用进行比较,对消毒物品清洗、包装、发放进行采样,并计算合格率,统计物品丢失率。结果研究组的清洗合格率、包装合格率及发放合格率为97.00%、97.80%、96.53%明显高于对照组的87.00%、92.80%、89.53%,且研究组消毒物品丢失率为0.80%低于对照组的3.20%,差异有统计学意义(P<0.05);研究组患者医院感染率为1.83%,其中消毒供应中心相关性医院感染率为0.42%,对照组患者感染率为4.73%,其中消毒供应中心相关性医院感染为1.94%,差异有统计学意义(P<0.05),研究组患者住院时间(14.34±4.59)d和住院费用(5859.44±384.58)元均显著低于对照组(20.39±4.45d,8573.84±558.39元),差异有统计学意义(P<0.05),两组患者共发生医院感染78例,检出病原菌138株。结论前馈控制能够显著提高消毒供应中心相关工作质量,降低消毒供应中心相关医院感染率,值得临床推广应用。

OBJECTIVE To observe the influence of feedforward control on central sterile and supply department（CSSD）-related nosocomial infections in surgery patients of orthopedics department so as to provide theoretical basis for control of the nosocomial infections.METHODS A total of 1184 patients who received surgical procedures in department of orthopedics of the hospital from Jan 2015 to Dec 2015 were chosen as the control group,and 1204 patients who received surgical procedures in department of orthopedics from Jan 2016 to Dec 2016 were set as the study group.The control group was treated with conventional approach for prevention and control of nosocomial infections,while the study group was treated with additional feedforward control based on the treatment of the control group.The incidence of nosocomial infections was recorded;the length of hospital stay and hospitalization cost were compared between the two groups of patients,the cleaning,packaging,and distribution of objects were sampled,the qualified rate was calculated,and the loss rate of objects was statistically analyzed.RESULTS The qualified rates of cleaning,packaging,and distribution of objects were respectively 97.00%,97.80%,and 96.53%in the study group,significantly higher than 87.00%,92.80%,and 89.53%in the control group;the loss rate of objects of the study group was 0.80%,lower than 3.20% of the control group（P〈0.05）.The incidence of nosocomial infection was 1.83%in the study group,4.73%in the control group;the incidence of CSSD-related nosocomial infection was 0.42%in the study group,1.94%in the control group,and there was significant difference（P〈0.05）.The length of hospital stay of the study group was（14.34±4.59）days,significantly shorter than（20.39±4.45）days of the control group;the hospitalization cost of the study group was（5859.44±384.58）yuan,significantly less than（8573.84±558.39）yuan of the control group（P〈0.05）.Totally 78 patients had the nosocomial infections in the two groups,and 138 strains of pathogens were isolated.CONCLUSION The feedforward control may remarkably improve the work quality in CSSD and reduce the incidence of CSSD-related nosocomial infections,and it is worthy to be promoted in the hospital.