基于SWOT法的风险评估对产妇医院感染的影响

Effect of SWOT-based risk assessment on nosocomial infections in puerpera

目的探讨基于SWOT法的风险评估对产妇医院感染的影响。方法选取2013年2月-2015年2月于医院产科住院的1896例产妇为对照组,选取2015年4月-2017年4月(经SWOT分析实施医院感染管理改进措施后)于医院产科住院的2012例产妇为试验组,统计两组医院感染率及感染部位,对发生医院感染患者分别取样进行菌株鉴定,统计SWOT法风险评估实施前后医护人员手卫生依从性、手卫生知识知晓、医院感染知识知晓和抗菌药物合理使用。结果试验组和对照组医院感染率分别为1.39%和4.54%(P=0.012);试验组和对照组感染部位均以呼吸系统为主,分别占46.43%和46.51%;对照组86例医院感染患者,共检出98株病原菌,其中革兰阴性菌52株,占53.06%,革兰阳性菌32株,占32.65%,真菌14株,占14.29%;试验组28例医院感染患者共检出32株病原菌,其中革兰阴性菌17株,占53.13%,革兰阳性菌10株,占31.25%,真菌5株,占15.62%;根据SWOT分析制定的措施实施后,医护人员手卫生依从性、手卫生知识知晓、医院感染知识知晓和抗菌药物使用合格率均提高(P<0.05)。结论用SWOT分析法风险评估有助于提高产科应对感染风险的能力和医院感染管理质量,从而降低医院感染率。

OBJECTIVE To explore the effect of SWOT-based risk assessment on nosocomial infections in puerpera.METHODS Totally 1896 puerpera who were hospitalized in department of obstetrics from Feb 2013 to Feb 2015 were chosen as the control group,and 2012 puerpera who were hospitalized in department of obstetrics from Apr2015 to Apr 2017（after the SWOT-based improvement measures of management of nosocomial infections were carried out）were assigned as the experimental group.The incidence rates of nosocomial infections and infection sites were statistically analyzed,the specimens were collected from the patients with nosocomial infections for identification of pathogens,and the hand hygiene compliance,rates of awareness of hand hygiene knowledge,rates of awareness of nosocomial infection knowledge and rates of reasonable use of antibiotics of health care workers were statistically analyzed before and after the SWOT-based risk assessment was carried out.RESULTS The incidence rate of nosocomial infection was 1.39%in the observation group,4.54%in the control group（P=0.012）.The patients with respiratory system infection accounted for 46.43%in the observation group,46.51%in the control group.A total of 98 stains of pathogens were isolated from 86 patients with nosocomial infections in the control group,52（53.06%）of which were gram-negative bacteria,32（32.65%）were gram-positive bacteria,and 14（14.29%）were fungi.Totally 32 strains of pathogens were isolated from 28 patients with nosocomial infections in the observation group,17（53.13%）of which were gram-negative bacteria,10（31.25%）were gram-positive bacteria,and 5（15.62%）were fungi.The hand hygiene compliance,rate of awareness of hand hygiene knowledge,rate of awareness of nosocomial infection knowledge and qualified rate of use of antibiotics were improved after the measures that were put forward based on SWOT analysis were carried out（P〈0.05）.CONCLUSION The SWOTbased risk assessment may facilitate the improvement of the capability of coping with the risk of infections and quality of management of nosocomial infections so as to reduce the incidence of nosocomial infections.