ICU多重耐药菌核心防控措施执行记录单的设计和应用

Design and application of ICU core control measures for multi-drug resistance bacteria

目的设计ICU多重耐药菌核心防控措施执行记录单并应用于临床。方法通过查阅指南和文献,设计ICU多重耐药菌核心防控措施执行记录单,将记录单应用于多重耐药菌感染患者中,比较记录单使用前后的医护人员核心防控措施执行率(医护人员知晓率、护理员知晓率、手卫生依从率、隔离医嘱落实率、隔离标识落实率、单间隔离或床旁隔离落实率、物品专用落实率)、物品表面消毒合格率、抗菌药物使用合格率及多重耐药菌感染发生率。结果应用ICU多重耐药菌核心防控措施执行记录单后,医护人员核心防控措施执行率、物品表面消毒合格率、抗菌药物使用合格率均提高,差异有统计学意义(χ^2=2.85~432.18,P<0.05或0.01);多重耐药菌感染发生率由15.7%(112/713)降低至6.8%(51/748),差异有统计学意义(χ^2=28.22,P<0.01)。结论ICU多重耐药菌核心防控措施执行记录单能提高多重耐药菌核心防控措施执行率,降低多重耐药菌感染发生率,规范医护人员针对多重耐药菌患者的操作。将ICU多重耐药菌核心防控措施执行记录单应用于多重耐药菌患者医院感染管理中,有助于提高护理质量,保障患者的安全。

Objective To design a record sheet of the core control measures for multi-drug resistant bacteria in ICU and apply it to clinical practice.MethodsThrough consulting the guidelines and literature,we designed the ICU core control measures to execute the record sheet and applied the record sheet to patients with multiple resistant bacteria infection.The implementation rate of the core control measures of medical personnel before and after the use of the record sheet(the awareness rate of medical personnel,the awareness rate of nursing staff,the compliance rate of hand hygiene,the implementation rate of isolation medical orders,the implementation rate of isolation marks,the implementation rate of single room isolation or bedside isolation,and the exclusive implementation rate of items),qualified rate of surface disinfection of articles,qualified rate of use of antimicrobial agents and incidence of multi-drug resistant bacteria infection were compared.ResultsAfter implementing the record sheet using the ICU multi-drug resistant bacteria core control measures,the implementation rate of medical personnel's core control measures,the conformity rate of surface disinfection of articles and the acceptance rate of antimicrobial drug use were all improved,the difference was statistically significant(χ^2=2.85-432.18,P<0.05 or 0.01);incidence of multi-drug resistant bacteria infection from 15.7%(112/713)to 6.8%(51/748),the difference is statistically significant(χ^2=28.22,P<0.05).ConclusionsThe implementation of ICU multi-drug resistant core control measures can improve the rate of implementation of multi-drug resistant core control measures,reduce the incidence of multi-drug resistant infections,and standardize the operation of medical personnel against multiple drug resistant bacteria.The application of ICU multi-drug-resistant core control measures to the management of nosocomial infections in patients with multiple drug-resistant bacteria will help improve the quality of care and ensure the safety of patients.