目标性监测及干预模式在预防重症监护病房医院感染的应用研究

Application of targeted Monitoring and intervention model in prevention of hospital infection in intensive care unit

目的探讨目标性监测及干预模式在预防重症监护病房医院感染中的应用价值。方法采用便利抽样的方法,随机选择2015年1月-2018年12月六安市人民医院重症监护病房住院患者2542例为研究对象,根据住院时间分为对照组1225例、观察组1317例。对照组实施预防医院感染全面综合性监测,观察组联合应用目标性监测及干预。比较两组医院感染、医院感染上报率、医务人手卫生执行情况。结果观察组泌尿道插管、气管切开、气管插管、呼吸机、动静脉插管、医院感染发生率均明显低于对照组(16.62%vs 29.25%,29.11%vs 41.06%,21.88%vs 37.50%,31.55%vs 45.30%,17.04%vs 28.42%,15.49%vs 24.33%)(χ^2=42.718,16.017,25.372,15.103,33.133,31.272,P<0.01);医护人员手卫生合格率、医院感染上报率明显高于对照组(90.21%vs 85.35%,96.08%vs 91.28%)(χ^2=7.874,4.425,P<0.05)。结论目标性监测及干预有助于发现重症监护病房医院感染危险因素,预防医院感染的发生。

Objective To explore the application of targeted monitoring and intervention model in preventing hospital infection in Intensive Care Unit(ICU).Methods Convenient sampling method was used to randomly select 2542 inpatients in the ICU from January 2015 to December 2018 as the research subjects.They were divided into the control group(1225 cases)and the treatment group(1317 cases)according to the length of stay.The control group implemented comprehensive monitoring to prevent nosocomial infections,while the treatment group applied targeted monitoring and intervention.Nosocomial infections,reported rates of nosocomial infections,and hand hygiene performance of medical staff were compared between tlie two groups.Results The incidence of urinary intubation,tracheotomy,tracheal intubation,ventilator,arteriovenous intubation,and nosocomial infectibns in the treatment group were significantly lower than those in the control group(16.62%vs 29.25%,29.11%vs 41.06%,21.88%vs 37.50%,31.55%vs 45.30%,17.04%vs 28.42%,15.49%vs 24.33%)(x^2=42.718,16.017,25.372,15.103,33.133,31.272,P<0.01);The qualified rate of hand hygiene and nosocomial infection of medical staff were significantly higher than those of the control group(90.21%vs 85.35%,96.08%vs 91.28%)(x^2=7.874,4.425,P<0.05).Conclusion Targeted monitoring and intervention can help to find the risk factors of nosocomial infection in the ICU and prevent the occurrence of nosocomial infection.