老年精神科住院患者院内感染风险评估量表的构建与应用研究

Construction and application of nosocomial infection risk assessment scale for geriatric psychiatry inpatients

目的 探讨老年精神科住院患者院内感染的独立危险因素,以此构建风险评估量表并提出相应的风险防控措施。方法 收集整理2018年6月至2019年12月该中心收治的1 480例老年精神科患者临床资料,并进行回顾性分析。根据是否发生院内感染将其分为感染组(487例)和非感染组(993例),同时选取2020年1-3月392例老年精神科住院患者进行对照。基于logistic回归分析确定院内感染的独立危险因素,形成风险评估量表和相应的院内感染风险防控措施,并对观察组进行风险评估。结果 老年精神科患者院内感染好发于第一季度,感染部位以上呼吸道和下呼吸道为主。感染组和非感染组在性别、年龄、住院时间等方面比较,差异有统计学意义(P<0.05)。logistic回归分析显示,院内感染独立危险因素包括住院时间长于15d、使用呼吸机、使用胃管、使用导尿管、合并肝脏疾病、住院前30d静脉注射抗生素。采取院内感染风险评估量表评估并给予相应干预措施后,患者住院期间院内感染发生率为19.39%,低于干预前的32.91%(P<0.001)。结论 基于logistic回归分析的风险评估量表可有效评估老年精神科患者院内感染风险,有利于实施针对性的风险防控措施,从而有效降低院内感染风险。

Objective To explore the independent risk factors of nosocomial infection in geriatric psychiatric inpatients,so as to construct a risk assessment scale and put forward corresponding risk prevention and control measures.Methods The clinical data of 1 480 geriatric psychiatric patients treated in the center from June 2018 to December 2019 were collected and analyzed retrospectively.According to the occurrence of nosocomial infection,they were divided into infection group(487 cases)and non infection group(993 cases).At the same time,392 geriatric psychiatric inpatients from January to March 2020 were selected for control.The independent risk factors of nosocomial infection were determined based on logistic regression analysis,the risk assessment scale and corresponding nosocomial infection risk prevention and control measures were formed,and the risk assessment was carried out for the observation group.Results The nosocomial infection of geriatric psychiatric patients occurred in the first quarter,mainly in the upper and lower respiratory tract.There were significant differences in gender,age,length of hospital stay and other indexes between the infection group and the non infection group(P<0.05).The logistic regression analysis showed that the independent risk factors of nosocomial infection included longer than 15 days of hospitalization,use of ventilator,use of gastric tube,use of urinary catheter,complicated with liver diseases,and intravenous antibiotics 30 days before hospitalization.After taking the nosocomial infection risk assessment scale and giving corresponding intervention measures,the incidence of nosocomial infection during hospitalization was 19.39%,lower than 32.91%before intervention(P<0.001).Conclusion The risk assessment scale based on logistic regression analysis can effectively evaluate the risk of nosocomial infection in geriatric psychiatric patients,which is conducive to the implementation of targeted risk prevention and control measures and effectively reduce the risk of nosocomial infection.