某综合三级医院3年医院感染现患率调查分析

Investigation on nosocomial infection prevalence rate of a hospital of Baoding in three years

目的通过对某综合三级医院2014—2016年医院感染现患率的调查进行比较分析,探讨医院感染的有效预防措施,为医院感染的防控提供科学依据。方法采取横断面调查的方法,查看全部住院患者医院感染的发生情况,并对2014年、2015年与2016年3次医院感染及抗菌药物的使用情况进行分析。结果 2014年、2015年和2016年的医院感染现患率分别为2.73%、2.08%、2.39%,差异无统计学意义;3年的例次感染率分别为3.00%、2.15%和2.53%,差异无统计学意义;下呼吸道仍是医院感染最主要的部位,其次为上呼吸道和泌尿道感染;近3年病原学送检率差异无统计学意义;2016年抗菌药物使用率最低,为29.49%,与2014年(36.61%)、2015年(35.63%)相比有较大辐度下降;泌尿道插管与呼吸机使用使相关感染率提高是造成医院感染的危险因素。结论医院感染现患率符合国家相关规范要求,需加强"三大管"的全员培训及"下沉式培训",强化泌尿道及呼吸道插管的无菌操作、加强护理、每日评估,并尽早撤管。另外,需加强抗生素的管控,指导医生合理使用抗生素,应用抗生素前及时采集微生物学标本送检。

Objective To learn the prevalence rate and related risk factors of the nosocomial infection in our hospital,and to explore the prevention and control measures through investigating the prevalence rate of hospital infection from 2014 to 2016 and provide scientific basis for the prevention and control of hospital infection.Methods The investigation of by bed,case survey and cross-sectional survey was performed,the nosocomial infection of all the hospitalized patients and the use of antibacterial agents in 2014,2015,and 2016 were analyzed.Results The hospital infection rates were 2.73%,2.08% and 2.39% in 2014,2015 and 2016 with no statistically siginificant difference.The cases infection rates were 3.00%,2.15% and 2.53% in the 3 years,which had no significant difference.The lower respiratory tract was the uppermost parts of the hospital infection,followed by the upper respiratory tract and urinary tract.The etiology delivering rate had no obvious difference in the recent3 years.The lowest rate of antibacterial agents usage was 29.49% in 2016,with a sharply decrease compared in 2014（36.61%）,2015（35.63%）.Urinary tract intubation and mechanical ventilation were the two factors causing the risk factor of hospital infection.Conclusion The hospital infection rates in accordance with relevant state regulations.we should continue to strengthen the whole hospital of training of ＂three great managements＂ and ＂falling training＂.we should strengthen the urinary tract and respiratory tract intubation of sterile operation,strengthen care,daily assessment and remove the tube as early as possible.In addition,the hospital infection rates now conform to the related national requirements in hospital,we should strengthen the control of antibiotics,guide the rational use of antibiotics,doctors should apply antibiotics in time and properly microbiological specimens should be examined before the usage.