精准化监管模式在多重耐药菌感染防控的应用研究

Application of precision management mode in prevention and control of multidrug-resistant organisms infection

目的探讨精准化监管模式在多重耐药菌(MDROs)感染预防控制的应用效果。方法对2014年1~12月检出的多重耐药菌感染住院患者963例实施常规监管,对2016年1~12月检出的多重耐药菌感染住院患者759例实施精准化监管,即设立目标管理菌预警平台、制定集束化防控措施并监督落实、加强多学科协作防控多重耐药菌感染,比较精准化监管前后各项防控措施落实率及环境清洁消毒合格率。结果实施精准化监管后,医生开具隔离医嘱的执行率、隔离标识落实率、床边必备物品落实率分别由41.33%、51.82%、46.52%升至91.57%、96.05%、93.81%。清洁工具和环境物表ATP检测合格率分别由40.12%、36.88%升至78.36%、85.66%,医务人员手卫生依从率由63.32%升至81.28%,实施前后比较,差异有统计学意义(均P<0.01)。结论实施精准化监管模式可提高临床医护人员对多重耐药菌防控措施的执行力,保证医院感染管理质量,对有效降低多重耐药菌医院感染发生率有重要作用。

Objective To explore the application effect of precision management mode on prevention and control of muhidrug resistant organisms（MDROs）infection. Methods Totally 963 patients detected with MDROs infection from Jan to Dec 2014 received conven- tional supervision, while other 759 patients with MDROs infection from Jan to Dec 2016 were supervised using precision manage ment mode, which included setting pre warning platform for target management bacteria, formulating bundle of prevention and control measures, supervising and implementing, and strenthening multidisplinary cooperation to prevent and control MDROs in- fection. The rate of implementation and the qualified rate of environment cleaning and disinfection were compared before and after the use of precision management. Results After the implementation of precision management, the execution rate of physicians＇ isola- tion order, isolation identifier and bedside necessities were increased from 41.33%, 51.82% and 46.52%to 91.57%, 96. 05%and 93.81% respectively. The qualified rate of cleaning instrument and object surface in environment detected by ATP detecting method were improved from 40.12%, 36.88% to 78.36%, 85.66%, and medical staff＇s compliance rate of hand hygiene was im- proved from 63.32%to 81. 28%, there were significant differences for these indicators before and after precision management （P〈0. 01 for all）. Conclusion The precision management mode can improve medical staff＇ s execution to prevent and control MDROs infection, ensure the quality of nosocomial infection management, and it play an important role in reducing the incidence of MDROs infection effectively.