三维质量理论干预对院内感染预防和控制效果分析

Analysis of the Effect of Three-dimensional Quality Theory Intervention on the Prevention and Control of Nosocomial Infections

目的探讨三维质量理论干预对院内感染的预防和控制效果。方法选取2017年1月—2019年12月我院住院患者作为研究对象,其中2017年1月—2018年12月入院患者为感控措施实施干预前对照,将2019年1—12月入院患者予以三维质量理论指导下干预措施作为干预后观察,比较干预前后院内各科室感染状况、患者感染部位、医院感染控制的执行状况及医护工作者手卫生情况。结果干预后,院内各科室感染总人数及总感染率较干预前显著下降,差异有统计学意义(P<0.05),且康复医学科、肺病科、脑病科、心血管科、肿瘤内科、骨伤科一区感染情况较干预前显著改善(P<0.05)。干预后,院内出现下呼吸道、上呼吸道、泌尿道及胃肠道、其他感染等各部位感染情况较干预前显著好转,差异有统计学意义(P<0.05)。干预后,患者安置合理、标识清晰、保洁用具专用和消毒合格、正确使用防护用品外出、转科检测等落实防控措施、医嘱、家属知晓防控知识、医疗废物处理等感控执行状况较干预前显著提高(P<0.05)。干预后,医生、医技人员、护士、实习生、工勤、陪护人员等医护工作者手卫生执行情况的依从率较干预前显著提高(P<0.05)。结论三维质量理论指导下感控督导小组干预措施对院内感染预防和控制具有较好效果,可有效降低院内感染情况,提高感控执行状况和医护工作者手卫生依从率,对于提高医疗质量具有积极意义。

Objective To discuss the effect of three-dimensional quality theory intervention on the prevention and control of nosocomial infections.Methods Inpatients in our hospital from January 2017 to December 2019 were selected as the research objects.Among them,patients admitted from January 2017 to December 2018 were pre-intervention controls for sensory control measures,and patients admitted from January to December 2019 were treated the intervention measures under the guidance of the three-dimensional quality theory were used as post-intervention observations to compare the infection status of each department in the hospital before and after the intervention,the patient's infection site,the implementation status of hospital infection control,and the hand hygiene of medical workers.Results After the intervention,the total number of infections and the total infection rate in each department in the hospital were significantly lower than before the intervention,the difference reached statistical significance(P<0.05),the infection in the first area of rehabilitation medicine department,pulmonary disease department,encephalopathy department,cardiovascular department,oncology department and orthopedics department was significantly improved compared with before the intervention(P<0.05).After the intervention,the infection of the lower respiratory tract,upper respiratory tract,urinary tract,gastrointestinal tract,and other parts of the hospital was significantly better than before the intervention,and the difference reached statistical significance(P<0.05).After the intervention,the patient’s placement is reasonable,the identification is clear,the cleaning equipment is dedicated and disinfected,the correct use of protective equipment goes out,the transfer to the department,the implementation of prevention and control measures,the doctor’s order,the family’s knowledge of prevention and control,and the treatment of medical waste are more intervened Significantly before(P<0.05).After the intervention,the compliance rate of medical workers such as doctors,medical technicians,nurses,interns,workers,and accompanying staff in hand hygiene implementation was significantly higher than before the intervention(P<0.05).Conclusion Under the guidance of the three-dimensional quality theory,the intervention measures of the sensory control supervision team have a good effect on the prevention and control of nosocomial infections,which can effectively reduce the situation of nosocomial infections,improve the implementation of sensory control and the hand hygiene compliance rate of medical workers,which is of positive significance for improving medical quality.