基层版“CATS”计划在预防与控制手术部位感染的实践

Practice of primary-level′CATS′strategy in prevention and control of surgical site infection

目的将预防手术部位感染(SSI)的循证感控措施与基层医疗机构实际结合制定基层版“CATS”计划并实践,评估计划的干预效果。方法对重庆市大足区人民医院2016-2018年实施基层版“CATS”计划前后进行SSI目标性监测,对SSI发生率数据进行比较和分析。结果实施“CATS”计划后,监测手术患者的SSI发生率为0.55%,较实施“CATS”计划前(1.56%)降低(χ^(2)=4.996,P=0.025)。按切口清洁度分类,清洁切口和清洁-污染切口手术,SSI发生率虽有所下降,但比较差异无统计学意义。按手术类别分类,监测的剖宫产术、疝手术、乳腺切除术、胆囊切除术和骨折内固定术SSI都有所降低,但比较差异均无统计学意义。结论结合基层医疗机构实际制定的循证SSI预防和控制措施可以有效降低SSI发生率,可以进行推广和复制。

OBJECTIVE To formulate the primary-level′CATS′strategy by combining the evidence-based medicine measures for prevention and control of surgical site infection(SSI)with the actual situation of grass-root medical institutions and evaluate the interventional effect.METHODS The targeted surveillance of SSI was carried out before and after the primary-level′CATS′strategy was implemented in the People′s Hospital of Dazu District in 2016-2018,and the incidence of SSI was compared and observed.RESULTS The incidence of SSI was 0.55%after the′CATS′strategy was implemented,significantly lower than 1.56%before it was implemented(χ^(2)=4.996,P=0.025).According to the cleanliness of incision,the surgeries were divided into the clean incision and the cleancontaminated incision surgery,though the incidence of SSI was decreased,there was no significant difference.According to the types of surgeries,cesarean section,hernia surgery,mastectomy,cholecystectomy and internal fracture fixation were monitored,and the incidence rates of SSI of all the surgeries were decreased,but there was no significant difference.CONCLUSIONThe evidence-based prevention and control measures for SSI that are formulated by combing the actual situation of grass-root medical institutions can effectively reduce the incidence of SSI and are worthy to be promoted.