某市二级医疗机构感染管理调查与分析

Investigation and Analysis of Infection Management in Secondary Medical Institutions in a City

目的调查广东省某市二级医疗机构医院感染管理状况,查找薄弱环节,提出改进对策。方法对某市卫生健康委员会管理的79家二级医疗机构感染管理工作进行问卷调查。结果35家(66.04%)公立医疗机构设置了独立院感部门,13家(50.00%)民营医疗机构设置了独立院感部门。79家医疗机构共有感染管理专职人员83人,以护理专业(54人,占65.06%)和中级职称(50人,占60.24%)为主,外出培训与进修人次数较少。75家(94.94%)二级医疗机构建立了医院感染病例报告及监测流程,仅10家采用信息化监测软件。各医疗机构2018年医院感染平均例次率为0.35%(0%~15.87%),低于广东省2018年现患率抽查结果。57家二级医疗机构制定了多重耐药菌管理制度和防控流程,多重耐药菌检出率与广东省和全国平均水平相近。12家二级医疗机构未开展开手卫生监测,2018年上报手卫生平均依从率为80.02%。结论二级医疗机构医院感染管理基本达到规范要求,但医院感染管理部门架构有待完善,专职人员队伍专业水平有待提高,医院感染管理质控监测能力不足,手卫生和多重耐药菌管理有待完善,民营医疗机构亟待同质化管理。

Objective To investigate the status of infection management in secondary medical institutions in a city in Guangdong,find out the problems and put forward the countermeasures.Methods A questionnaire survey was conducted on infection management in secondary medical institutions managed by municipal health commission in a city.Results A total of 35(66.04%)public medical institutions and 13(50.00%)private medical institutions had independent department for infection management.There were 83 full-time staff in infection management in 79 medical institutions,mainly majoring in nursing(54 persons,65.06%)and medium-grade professional title(50 persons,60.24%),and the number of training and further study was less.75(94.94%)secondary medical institutions established the procedure of nosocomial infection case reporting and monitoring,and only 10 of them adopted the information monitoring software.The average rate of hospital-acquired infection in medical institutions in 2018 was 0.35%(0~15.87%),which was lower than that in Guangdong province in 2018.57 secondary medical institutions had formulated management policies and prevention and control procedures for multidrug-resistant bacteria,and the detection rate of multidrug-resistant bacteria was similar to the average level of Guangdong and the national average.12 secondary medical institutions did not carry out manual hygiene monitoring,and the average compliance rate of hand hygiene was 80.02%in 2018.Conclusion The nosocomial infection management in secondary medical institutions basically met the standard requirements,but the nosocomial infection management departments and personnel allocation need to be strengthened,the quality control and monitoring capabilities of the hospital infection management are insufficient,and the management of hand hygiene and multi-drug resistant bacteria needs to be improved.Private medical institutions are in urgent need of homogeneous management.