医院感染风险评估模型的建立与应用

Establishment and application of risk assessment model for nosocomial infections

目的建立医院感染风险评估模型,探讨利用医院感染风险评估模型预防和控制医院感染的有效性。方法 2012-2015年共调查住院患者4 725例,对相关的14个危险因素进行logistic回归分析,根据优势比建立医院感染风险评估模型和评估表对住院患者进行风险评估,评分≥8分定义为医院感染高风险患者;选取2015年7-12月92例高风险患者为对照组,采取常规管理措施,选取2016年1-6月98例高风险患者为实验组,采取集束化管理措施,对比分析两组患者的医院感染情况。结果 logistic回归分析结果显示,年龄≥65岁、慢性全身性疾病、免疫缺陷、昏迷、气管切开、使用呼吸机是医院感染的主要危险因素,实验组的医院感染率较对照组明显降低,差异有统计学意义(χ~2=4.595,P=0.032)。结论根据危险因素建立医院感染风险评估模型,对高风险患者采取集束化管理措施,可有效降低和控制医院感染。

OBJECTIVE To explore the effectiveness of risk assessment model for nosocomial infections in prevention and control of nosocomial infections.METHODS A total of 4 725 hospitalized patients were investigated from 2012 to 2015,the logistic regression analysis was carried out for 14 related risk factors,the risk assessment model for nosocomial infection and assessment form were established based on odds ratio so as to conduct the risk assessment for the hospitalized patients,and the patients whose score were no less than 8 points were defined as the high risk for nosocomial infections.Totally 92 patients who were at high risk of nosocomial infections and treated from Jul 2015 to Dec 2015 were chosen as the control group and were treated with conventional management measures,while 98 patients who were at high risk of nosocomial infections and treated from Jan 2016 to Jun 2016 were assigned as the experimental group and were given cluster management measures.The incidence of nosocomial infections was observed and compared between the two groups of patients.RESULTS The result of the logistic regression analysis indicated that the major risk factors for the nosocomial infection included the no less than 65 years of old,chronic systemic disease,immune deficiency,coma,tracheotomy and use of ventilator.The incidence of nosocomial infections of the experimental group was significantly lower than that of the control group（χ^2=4.595,P=0.032）.CONCLUSION It is an effective way to establish the risk assessment model for nosocomial infections based on the risk factors and take the cluster management measures for the high-risk patients so as to reduce and control the incidence of nosocomial infections.