基于区县医院感染管理现状调研的SOWT分析

SOWT analysis based on investigation of current status of management of nosocomial infections in county hospitals

目的调查区县医院感染管理现状,运用SWOT分析其优劣势及发展的内外部环境,为区县医院制定中长期医院感染管理策略提供依据。方法采用现场检查与访谈相结合方式,于2015年12月-2016年4月调研淄博市28所区县医院感染管理现状,并将区县医院分为综合型与专科型两组对比,应用SWOT分析法对区县医院感染内部环境中的优势、劣势和外部环境中的机会、威胁进行综合分析,剖析区县级医院医院感染防控整体管理与发展情况。结果 82.14%区县医院感染管理组织已健全,但预防控制管理工作水平尚不均衡,综合型医院在CAUTI监测、环境卫生学监测、灭菌效果监测、信息化软件数据收集、手术室布局及内镜室布局方面明显优于专科型医院(P<0.05);手卫生依从性上,区县综合医院明显高于专科医院(P<0.05)结论区县医院感染管理工作优势是管理体系及制度健全,能有效开展院感培训、监测工作,劣势是风险管理、管理人员核心能力建设、重点科室管理、院感文化建设等工作仍有缺失,区县医院感染管理工作应积极面对医改背景下分级诊疗实施带来的机遇与挑战,紧跟医院发展脚步,做好精细化、深层次的规范感染管理工作。

OBJECTIVE To investigate the current status of management of nosocomial infections in county hospi- tals and observe the advantages and disadvantages as well as the internal and external environment of development so as to provide guidance for formulating the medium and long term strategies for control of nosocomial infections. METHODS By means of onsite inspection combined with interview, the current stats of management of nosocomial infections in 28 county hospitals of Zibo was investigated from Dec 2015 to Apr 2016, the enrolled hospitals were divided into the general hospital group and the specialized hospital group.The advantages and disadvantages of in- ternal environment of nosocomial infections and the opportunities and threats of external environment were com- prehensively analyzed by means of SWOT analysis, and the overall status of management and development of pre- vention and control of nosocomial infections in the county hospitals was dissected.RESULTS The nosocomial infec- tions management organizations have been gradually perfected in 82.14% of the county hospitals, the levels of pre- vention and control of nosocomial infections were imbalanced in the county hospitals. The general hospitals were significantly superior to the specialized hospitals in the surveillance of CAUTI, monitoring of environmental hy- giene, monitoring of sterilization effect, information software data collection, layout of operating rooms, or layout of endoscopy rooms （P〈0.05）.The hand hygiene compliance was significantly higher in the general hospitals than in the specialized hospitals （P〈0.05）.CONCLUSlON The advantages of management of nosocomial infections inthe county hospitals include the sound management systems and effective conduct of training and monitoring, while the disadvantage is the absence of risk management, core competence construction of management staff, management of key departments and cultural construction of infection control.It is necessary for the nosocomial in- fections management in the county hospitals to positively face the opportunities and challenges that are brought by the hierarchical diagnosis and treatment in the practice of healthcare reform and keep in step with the development of hospital so as to standardize the management of nosocomial infections.