ICU患者发生医院感染与家属探视模式的相关因素分析

Analysis of related factors of nosocomial infections and family visit in ICU patients

目的研究家属探视模式对ICU患者发生医院感染的影响,为找到科学的人性化的探视方法做支撑,从而满足患者和家属的探视需求。方法选取2015年1月-2016年12月医院ICU收治的重症患者260例为研究对象,其中2015年1月-2015年12月收治的130例患者为对照组采取弹性探视制度;2016年1月-2016年12月收治的130例患者为研究组采取限制性探视制度;记录并观察患者是否发生感染,对ICU空气环境进行监测,分析空气中病原菌菌株分布,研究限制性探视模式对患者医院感染的相关影响因素。结果研究组有36例患者感染,感染率为27.69%,对照组34例患者感染,感染率为26.15%;研究组36例感染患者共检出菌株102株,以革兰阳性菌为主,共72株占70.59%,对照组34例感染患者共检出菌株99株,以革兰阳性菌为主,共72株占72.73%;多因素非条件Logistic分析显示,每次探视时间、每天探视人数能够增加患者感染的风险,每天仪器表面消毒剂擦拭次数及每天动态空气消毒次数则能够降低患者感染的风险(P<0.05)。结论和弹性探视制度相比,限制性探视制度未增加医院感染的风险,为科学的人性化的探视方法。

OBJECTIVE To investigate the effect of family visit mode on nosocomial infections in ICU patients,so as to support the visit of patients with medical and humanized visits to meet the needs of patients and their families.METHODS A totl of 260 severe patients in ICU of our hospital from Jan.2015 to Dec.2016 were chosen as the research objects.Totally 130 patients from Jan.2015 to Dec.2015 with flexible visit system were set as control group,and 130 patients from Jan.2016 to Dec.2016 with a restrictive visit were set as study group.Whether or not with infections were recorded and observed,the ICU air environment was monitored to analyze the distribution of pathogens in air,and the influencing factors of restrictive visit mode on nosocomial infections in patients were analyzed.RESULTS There were 36 cases of infections in study group,with the infection rate of 27.69%,and 34 cases of infections in control group,with the infection rate of 26.15%.Totally 102 strains were detected in 36 cases of infected patients of study group,which were mainly 72 strains of gram-positive bacteria,accounting for70.59%,and 99 strains were detected in 34 cases of infected patients of control group,which were mainly 72 strains of gram-positive bacteria,accounting for 72.73%.Multivariate unconditional logistic analysis showed that the per visit time and the number of visits per day could increase the risk of infections,while the times of instrument surface cleaning and the times of daily dynamic air disinfection could reduce the risk of infections（P〈0.05）.CONCLUSIONCompared with flexible visit system,restrictive visit system does not increase the risk of nosocomial infections,which is a scientific and humanized visit method.