一级医疗机构医院感染现患率调查误差分析与改进对策

Error analysis and improvement countermeasures of prevalence survey of nosocomial infections in community health service centers

目的分析与探讨宝山区一级医疗机构医院感染现患率调查中存在的误差并提出相应对策。方法组织9所设有住院病房的一级医疗机构,对其2017年12月12日所有住院患者进行医院感染现患率调查。并于2018年3月对医院上报的数据进行复核。将上报数据与复核数据进行比较,分析产生误差的原因,并提出解决方法。结果实际调查住院患者379例,实查率为100.00%;复核病例379例,复核率为100.00%。通过数据比对,上报数据中医院感染病例12例,现患率为3.17%,复核数据中医院感染病例26例,现患率为6.86%,医院感染病例漏报率为53.85%(14/26);上报数据中抗菌药物使用率为5.54%(21/379),复核数据中抗菌药物使用率为9.50%(36/379),抗菌药物使用病例漏报率为41.67%(15/36);病原学送检率偏低为8.33%(3/36)。结论发现一级医疗机构医院感染现患率调查中存在漏报,应采取有针对性的改进对策,推进医院感染现患率调查在一级医疗机构应用普及。

OBJECTIVE To analyze the errors in the prevalence survey of nosocomial infections（NIs）in community health service centers in Baoshan district and to put forward the corresponding countermeasures.METHODS A survey of NIs was undertaken in 9 community health service centers on Dec.12,2017,and the reported data by hospitals were reassessed in Mar.2018.The reported data were compared with the reassessed data,the causes of the errors were analyzed,and solutions were proposed.RESULTS A total of 379 patients were surveyed and the actual investigated rate was 100%.Totally 379 patients were reassessed,and the reassessment rate was 100.00%.The survey data showed that there were 12 patients with HAIs and the prevalence was 3.17%.The reassessment data showed that there were 26 patients with HAIs and the prevalence was 6.86%.The rate of missing report was53.85%（14/26）.The survey data showed that the utilization rate of antimicrobials was 5.54%（21/379）.The reassessment data showed that the utilization rate of antimicrobials was 9.50%（36/379）.The rate of missing report of the utilization rate of antimicrobials was 41.67%.The submission rate for specimen was low,which was 8.33%（3/36）.CONCLUSIONThere are some missing reports in the prevalence survey of NIs in community health service centers.Targeted measures should be taken to promote the popularization of prevalence survey of NIs in community health service centers.