医院感染数据周反馈及专职医院感染监管对医院感染率的影响

The impact of weekly data feedback and full-time supervision on nosocomial infection control

目的探讨医院感染(简称"院感")数据每周公示反馈及专职院感监管人员对院感率的影响。方法回顾性分析2014年1月至2016年12月山东大学附属省立医院重症医学科院感率及漏报率数据情况,比较院感数据周反馈及专职院感监管前后院感率及漏报率变化。院感数据周反馈包括:每周一晨会公示上周科内各医生分管床位的患者,是否存在院内感染、院感病原学、是否多重耐药菌、是否上报、是否张贴隔离标识、是否隔离。专职院感人员每日监管内容包括:全体医务人员手卫生、医疗护理无菌操作、协调监督物业人员(门卫、护理员、保洁)工作、科室仪器物品等表面每日消毒、维持科室环境整洁。结果院感数据周反馈实施前后我科院感率分别为9.90%(199/2019)、5.50%(124/2239),差异具有统计学意义(χ2=28.239,P <0.001);专职院感监管实施前后院感率分别为8.40%(83/993)、3.30%(41/1246),差异具有统计学意义(χ2=27.131,P <0.001);院感数据周反馈及专职院感监管实施后院感漏报率降为0(Z=-4.538,P=0.00)。结论每周院感数据反馈可降低院感率,专职院感监管可进一步降低院感率;周院感数据反馈及专职院感监管可提高院感管理依从性,减少院感漏报率。

ObjectiveTo investigate the impact of weekly data feedback and full-time supervision on nosocomial infection control. MethodsA retrospective study was conducted to analyze the incidence of nosocomial infection in our ICU and the rate of missing report from January, 2014 to December, 2016. A weekly nosocomial infection data feedback included： publicity of nosocomial infection data of each beds from each doctor in charge, i.e. incidence of nosocomial infection, nosocomial pathogens, multidrug-resistant bacteria, reporting of infection, isolation and noti？cation of nosocomial infection. Daily full-time supervision included： hand hygiene of all medical staff, aseptic medical procedures, coordination and supervision of auxiliary person （guards, caregivers, cleaners）, daily disinfection of equipments, environment in the unit. ResultsThe nosocomial infection rate before and after the implementation of weekly data feedback were 9.90% （199/2019） and 5.50% （124/2239） respectively, with a statistically signi？cant difference （χ2=28.239, P 〈 0.001）. The nosocomial infection rate before and after the implementation of full-time supervision were 8.40% （83/993） and 3.30% （41/1246） respectively, with a statistically signi？cant difference （χ2=27.131, P 〈 0.001）. The rate of missing report for nosocomial infection decreased to 0 after the implementation of weekly data feedback and full-time supervision （Z=-4.538, P=0.00）. ConclusionWeekly data feedback may reduce nosocomial infection rate. Full-time supervision may further reduce the nosocomial infection rate. Weekly data feedback weekly and full-time supervision may improve the compliance of nosocomial infection control and quality of management.