新生儿重症监护室<34周的早产儿医院感染质量改进前后对比观察

Observation on pre and post nosocomial infection quality improvement of hospital infection <34 weeks in neonatal intensive care unit

目的:通过对新生儿重症监护室(NICU)的医院感染进行质量改进前后临床观察,探讨控制NICU医院感染更有效的质量改进措施。方法:通过分析NICU 2015年5月~2016年4月院感相关基线数据及造成院感的所有可能因素,并从2016年5月~2017年4月进行为期1年的相关改进措施,通过总结并对比分析质量改进前后的效果,为进一步实施质量改进措施提供可靠的依据和理论基础。结果:质量改进前后,NICU总的医院感染发生率分别为7.68%和5.88%.其中,呼吸机相关性肺炎的发病率分别为4.39%和2.31%。NICU医院感染以血流感染(PICC相关和败血症)为主,致病菌以革兰阴性杆菌鲍曼不动杆菌为主。结论:持续质量改进是一种前瞻性的有效控制院感监测方法,应加强NICU院感的定期监测和分析,在此基础上实施有效的医院感染综合防治措施,降低NICU医院感染的发生率。

Objective To investigate the quality improvement measures of nosocomial infection in neonatal intensive care unit(NICU)before and after quality improvement before and after quality improvement in our hospital,and to explore effective measures to control NICU nosocomial infections.Method Through the analysis of NICU hospital-related baseline data from May 2015 to April 2016 and all possible factors causing hospital-related sensation in our hospital,and from May 2016 to April 2017,the relevant improvement measures were carried out for one year,the results were summarized and analyzed before and after the improvement of the quality,to provide reliable basis and theoretical basis for the further implementation of quality improvement measures.Results Pre and post the quality improvement,the total nosocomial infection rate of NICU in our hospital was 7.68%and 5.88%,respectively,and the incidence of ventilator-associated pneumonia was 4.39%and 2.31%,respectively.The main infection of NICU hospital in our hospital was blood flow infection(PICC related and septicaemia),and the pathogenic bacteria were mainly gram-negative bacilli,Acinetobacter Bauman.Conclusion Continuous quality improvement is a prospective and effective method for monitoring hospital sense.We should strengthen the regular monitoring and analysis of hospital sense in NICU,and implement effective nosocomial infection prevention and control measures so as to reduce the incidence of NICU nosocomial infection.