飞行检查对危重新生儿医院感染的预防控制效果研究

Effect of flying inspection on prevention and control of nosocomial infections in hospitalized critically sick neonates

目的探讨飞行检查对住院危重新生儿医院感染的预防控制效果。方法对医院2012年1月-2015年12月新生儿重症监护室(NICU)实施飞行检查预防控制管理医院感染,2008年1月-2011年12月为未实施阶段;比较实施飞行检查前后医院感染率,手卫生依从率、洗手正确率、手卫生知识知晓率、医院感染知识知晓率,环境卫生抽查监测合格率和医务人员手监测合格率;医院感染患儿进行病原菌检测。结果飞行检查实施前NICU入住患儿共4588例,医院感染202例,感染率为4.40%;飞行检查实施后NICU入住患儿共5754例,医院感染160例,感染率为2.78%;飞行检查实施后NICU医院感染率显著低于实施前(P<0.05);飞行检查实施前202例医院感染患儿,共检出257例病原菌,其中革兰阳性菌106株,占41.25%,革兰阴性菌141株,占54.86%,真菌10株,占3.89%;飞行检查实施后160例医院感染患儿,共检出199例病原菌,其中革兰阳性菌80株,占40.20%,革兰阴性菌111株,占55.78%,真菌8株,占4.02%,实施前后,医院感染病原菌构成比较差异无统计学意义;与飞行检查实施前相比,飞行检查实施后手卫生依从率、洗手正确率、手卫生知识知晓率、医院感染知识知晓率,环境卫生抽查监测合格率和医务人员手监测合格率均显著提高(P<0.05)。结论飞行检查方法用于住院危重症新生儿医院感染的预防控制管理,有助于提高医护人员手卫生状况和相关知识知晓率,从而降低医院感染的发生率。

OBJECTIVE To explore the effect of flying inspection on prevention and control of nosocomial infections in hospitalized critically sick neonates.METHODS From Jan 2012 to Dec 2015,the flying inspection was carried out to prevent and control nosocomial infections in neonatal intensive care unit（NICU）,it was not carried out from Jan 2008 to Dec 2011.The incidence of nosocomial infections,hand hygiene compliance rate,rate of correct hand washing,awareness rate of hand hygiene knowledge,awareness rate of nosocomial infection knowledge,qualified rate of spot monitoring of environmental hygiene,and qualified rate of monitoring of health care workers＇ hands were compared before and after the flying inspection was carried out;the pathogens isolated from the neonates with nosocomial infections were detected.RESULTS Of totally 4588 children who were hospitalized the NICU before the flying inspection was carried out,202 had nosocomial infections,with the incidence rate of infections 4.40%.Of totally 5754 children who were hospitalized the NICU after the flying inspection was carried out,160 had nosocomial infection,with the incidence rate of infection 2.78%;the incidence rate of nosocomial infections in the NICU was significantly lower after the flying inspection was carried out than before it was carried out（P〈0.05）.A total of 257 strains of pathogens were isolated from the 202 children with nosocomial infection before the flying inspection was carried out,including 106（41.25%）strains of gram-positive bacteria,141（54.86%）strains of gram-negative bacteria,and 10（3.89%）strains of fungi;totally 199 strains of pathogens were isolated from the160 children with nosocomial infections after the flying inspection was carried out,including 80（40.20%）strains of gram-positive bacteria,111（55.78%）strains of gram-negative bacteria,and 8（4.02%）strains of fungi.There was no significant difference in the constituent ratios of pathogens before and after the flying inspection was carried out.The hand hygiene compliance rate,rate of correct hand washing,awareness rate of hand hygiene knowledge,awareness rate of nosocomial infection knowledge,qualified rate of spot monitoring of environmental hygiene,and qualified rate of monitoring of health care workers＇ hands were significantly improved after the flying inspection was carried out.CONCLUSION The flying inspection,as is applied for prevention and control of the nosocomial infections in the hospitalized critically sick children,may facilitate the improvement of hand hygiene of health care workers so as to reduce the incidence of nosocomial infections.