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透明监管在多重耐药菌管理中的应用研究 被引量:11

Application of transparent supervision in the multidrug-resistant organism management
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摘要 目的探讨透明监管模式在多重耐药菌(MDRO)防控中的实践和效果。方法对监测科室MDRO管理采取透明监管模式进行干预,包括借助信息化手段对MDRO患者进行透明监管,以及透明公开MDRO防控相关指标。透明公开的指标包括手卫生依从率、环境物体表面ATP采样合格率、MDRO主要防控措施落实率、MDRO检出率和医院感染发病率。采用卡方检验比较干预前后数据。结果干预后,监测科室手卫生依从率由49.83%提高至65.61%(χ2=47.389,P〈0.001);环境物体表面ATP采样合格率由48.50%提高至83.33%(χ2=96.115,P〈0.001);开具隔离医嘱、配备隔离标识、床边配备专用设备落实率均明显升高,与干预前比较差异有统计学意义(P〈0.001); MDRO检出率由75.08%降至63.31%(χ2=28.123,P〈0.001);医院感染发病率由4.77%下降至3.47%(χ2=20.303,P〈0.001)。结论实施透明监管可以有效降低MDRO在医院内传播的风险,对保障医疗质量和患者安全具有重要意义。 Objective To explore the practice and effect of transparent supervision in the prevention and control of multidrug-resistant organism (MDRO).Methods Transparent supervision was introduced to intervene into the MDRO management of monitored departments. Such transparent supervision was aided by IT means, and transparent MDRO control indexes. These indexes included hand hygiene compliance rate, qualification rate of ATP detection of environmental object surface, implementation rate of main MDRO prevention and control measures, MDRO resistance rate, and nosocomial infection incidence. The data before and after the intervention were compared by Chi square test to evaluation the effect.Results After intervention, the hand hygiene compliance rate increased from 49.83% to 65.61% (χ2=47.389, P〈0.001), and the qualification rate of ATP detection of environmental object surface increased from 48.50% to 83.33% (χ2=96.115, P〈0.001). Meanwhile, such indexes as prescription of patient isolation, placement of isolation identifiers and that of specialized bedside equipments increased significantly(P〈0.001). The MDRO detection rate decreased from 75.08% to 63.31% (χ2=28.123, P〈0.001), and the incidence of nosocomial infection decreased from 4.77% to 3.47%(χ2=20.303, P〈0.001).Conclusions The practice of transparent supervision could reduce the risk of MDRO transmission at hospitals effectively, proving its importance in ensuring medical quality and patient safety.
作者 谭莉 梁艳芳 许川 涂敏 熊薇 徐敏 赖晓全 Tan Li;Liang Yanfang;Xu Chuan;Tu Min;Xiong Wei;Xu Min;Lai Xiaoquan(Department of Hospital Infection Management,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Chin)
出处 《中华医院管理杂志》 CSCD 北大核心 2018年第8期667-670,共4页 Chinese Journal of Hospital Administration
基金 国家自然科学基金(71473098)
关键词 感染控制 透明监管 多重耐药菌 医院感染管理 防控措施 Infection control Transparent supervision Muhidrug-resistant organism Nosocomial infection management Prevention and control measure
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