长沙市养老机构医院感染管理现状

Current situation of healthcare-associated infection management in old-age care institutions in Changsha

目的了解长沙市养老机构医院感染管理现状。方法采用实地调查与书面调查的方法调查长沙市医养结合型养老机构医院感染防控工作现状,填写《养老机构医院感染管理调查问卷》,对医务人员进行医院感染知识测评,统计分析相关数据。结果共调查40所养老服务机构,共有148名医务人员填写测评问卷。40所养老机构中仅3所(7.5%)设置有独立医院感染管理部门且配备专职医院感染管理人员。不同规模养老机构医院感染管理相关制度制定情况得分比较,差异有统计学意义(F=12.058,P<0.001)。医院感染核心制度中得分较高的为:安全注射制度(5.08±0.66)分、无菌操作制度(4.35±0.48)分、职业暴露与防护制度(3.38±0.77)分。除无菌操作制度与感染报告制度,不同规模养老机构其他核心制度落实情况得分比较,差异均有统计学意义(均P<0.05)。医务人员医院感染知识测评总合格率为62.2%,总分为(55.58±8.52)分。得分较高的为:医院感染预防与控制(13.00±4.33)分、医院感染基本知识(12.30±3.45)分、医疗废物管理(10.96±3.80)分。除职业暴露与标准预防、医院感染监测与报告两个知识点,不同岗位类型医务人员其他知识点得分比较,差异均有统计学意义(均P<0.05)。结论养老机构医院感染管理组织欠完善,相关核心制度未落实到位,应加大扶持和监管力度,加强医务人员医院感染知识培训,尽快完成地方标准的养老机构医院感染控制规范。

Objective To understand the current situation of healthcare -associated infection (HAI) management in old-age care institutions in Changsha. Methods On-site and written survey were adopted to investigate current situa-tion of HAI prevention and control in old-age care institutions in Changsha, questionnaire on HAI management in old-age care institutions was filled in, knowledge about HAI among health care workers (HCWs) was evaluated and relevant data were analyzed. Results A total of 40 old-age care institutions were surveyed, 148 HCWs filled in the questionnaire. Only 3 of 40 old-age care institutions (7.5%) had independent HAI management departments and full-time HAI management personnel. There was a significant difference in the scores of HAI management system in different scales of old-age care institutions ( F =12.058, P <0.001 ). The higher scores in the scoring system of HAI were: safe injection system (5.08±0.66), aseptic operation system (4.35±0.48), occupational exposure and protection system (3.38±0.77). Except for aseptic operation system and infection reporting system, there were significant differences in scoring of implementation of other core systems in different scale of old-age care institutions (all P < 0.05). The total qualified rate of knowledge assessment of HAI among HCWs was 62.2%, and the total score was (55.58±8.52). The high scores were as follows: prevention and control of HAI (13.00±4.33), basic knowle - dge of HAI (12.30±3.45), and management of medical waste (10.96±3.80). Except for occupational exposure and standard prevention as well as HAI surveillance and report, scores of other knowledge among HCWs in diffe -rent occupations were all significantly different (all P <0.05). Conclusion HAI management organization of old-age care institutions is not perfect, and core system is not implemented. Support and supervision should be enhanced, training for HCWs should be strengthened, and formulation of HAI control standard in local old-age care institutions should be completed as soon as possible.