某三甲医院感控联络护士现状及培训模式探讨

Discussion on status and and training model of infection control link nurses in a third-class hospital

目的分析感控联络护士(Infection control link nurses,ICLNs)现状,探讨其针对性培训模式,提高培训效率。方法设计调查问卷,利用ICLNs微信群采用"问卷星"线上调查某大型三甲医院ICLNs相关情况。收集2016年6月-2019年3月ICLNs微信群问题,将其分为针对性培训前2016年6月-2017年10月(第一阶段)和针对性培训后2017年11月-2019年3月(第二阶段),2017年11月针对第一阶段ICLNs微信群问题进行针对性培训。分析比较第一阶段和第二阶段ICLNs微信群问题种类及数量、医院感染率等变化。结果共117位ICLNs参与本次调查,基本情况特点为以女性、30~39岁年龄段、11~20年工作年限、主管护师职称、从事ICLNs 3年以上为主。90%以上的ICLNs同时承担了观察科室工作人员手卫生依从性、医疗废物管理工作、督查科室消毒隔离执行情况、配合感控科做好感控各项监测工作及督察医护人员无菌操作等工作。仅有80.34%的ICLNs可完成对新入科医务人员的培训工作。ICLNs更倾向于使用ICLNs微信群与感控科交流(76.07%),认为建立微信群非常有必要(75.21%),对他们工作中遇到的感控问题很有帮助(79.49%),且感控科能经常及时解决他们在实际工作中遇到的感控相关疑惑(96.58%),ICLNs觉得感控科针对性培训效果很好(82.05%)。第二阶段ICLNs微信群问题数量,医疗废物类、消毒隔离类及其他类问题数量均比第一阶段有所减少,其中医疗废物类问题数量减少有统计学意义(P<0.05),职业防护类问题数量有所增加,差异有统计学意义(P<0.05)。第二阶段医院感染率(1.73%)、感染例次率(1.96%)较第一阶段感染率(2.06%)、感染例次率(2.30%)降低(均P<0.001)。结论通过定期搜集ICLNs微信群问题并进行针对培训的模式可以有效解决临床ICLNs的困惑,大大提高培训的效率及精准性。

OBJECTIVE To analyze the current status of infection control linke nurses(ICLNs),explore its targeted training model and improve the training efficiency.METHODS A questionnaire was designed and a star questionnaire by ICLNS WeChat group was used to investigate the Infection control link nurses(ICLNs)related situation in a large third-class hospital.Questions of ICLNs WeChat group from Jun.2016 to Mar.2019 were collected and divided intobefore the targeted training from Jun.2016 to Oct.2017(stage 1)and after the targeted training from Nov.2017 to Mar.2019(stage 2).In November 2017,targeted training was provided for the first phase of ICLNs WeChat group issues.The number and types of ICLNs WeChat group and nosocomial infection rate were analyzed and compared between the first and the second stage.RESULTS A total of 117 ICLNs participated in the survey,and the basic characteristics were female,30-39 years old,11-20 years of working experience,professional title of nurse in charge,and more than 3 years of ICLNs.More than 90%of ICLNs had also undertaken tasks of observing the compliance of hand-hygiene,medical waste management,supervision of the implementation of disinfection and isolation of department,cooperating with the infection control department to do the monitoring work of infection control and supervising the aseptic operation of medical staff.However,only 80.34%of ICLNs could complete the training of newly admitted medical staff.ICLNs were more inclined to use ICLNs WeChat group to communicated with the Sensation and Control Section(76.07%).They believed that the establishment of WeChat group was very necessary(75.21%),and it was helpful for the sensory control problems encountered in their work(79.49%).And the infection control department could often solve the control-related doubts they encountered in actual work in time(96.58%).ICLNs thought that the targeted training of control department was effective(82.05%).The number of ICLNs Wechat group problems,medical waste,disinfection and isolation,and other types of problems in the second stage,decreased compared with the first stage.The number of medical waste problems were reduced compared to the first stage(P<0.05).Among them,the number of medical waste problems decreased significantly(P<0.05),the number of occupational protection problems increased significantly(P<0.05).The nosocomial infection rate(1.73%)and infection rate(1.96%)in the second stage were significantly lower than the infection rate(2.06%)and infection rate(2.30%)in the first stage(allP<0.001).CONCLUSION By regularly collecting ICLNs WeChat group problems and conducting training-oriented models,the confusion of clinical ICLNs could be effectively solved,greatly improving the efficiency and accuracy of training.