“信息化+多学科协作”管理模式在多药耐药菌防控中的应用

Application of ’informatization plus multidisciplinary cooperation’ management mode in prevention and control of multidrug-resistant organisms

目的 探讨“信息化+多学科协作”管理模式在多药耐药菌(MDROs)防控中的实践效果,为有效控制医院内MDROs的发生和传播提供方法学依据。方法 采用信息化手段对华中科技大学同济医学院附属同济医院2018年-2020年住院的MDROs患者进行实时监测和预警,并成立多学科协作工作组,多部门共同合作采取综合防控策略,同时定期召开会议,以问题为导向进行原因分析并提出拟解决和持续改进措施,并通过分析MDROs防控措施落实率、环境物表MDROs检出率、MDROs医院感染发生率以及MDROs检出率,综合评价防控效果。结果 总MDROs防控措施落实率从2018年的66.59%上升至2020年的91.62%(P<0.001);环境物表多药耐药菌总检出率从2018年的8.23%下降至2020年0.12%(P<0.001);总的多药耐药菌医院感染发生率从2017年的0.296%下降至2020年的0.112%(P<0.001);总的多药耐药菌检出率从2017年的67.24%下降至2020年的25.80%(P<0.001)。结论 通过实施“信息化+多学科协作”管理模式,提高了医务人员MDROs防控措施的执行力,并有效降低了住院患者中多药耐药菌的感染和检出情况,值得推广应用。

OBJECTIVE To explore the effect of ’informatization plus multidisciplinary cooperation’ management mode on prevention and control of multidrug-resistant organisms(MDROs) so as to provide scientific basis for effective control of MDROs. METHODS The information technology was adopted to carry out real-time monitoring and early warning for the MDROs patients who were hospitalized in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2018 to 2020. A multi-disciplinary cooperation working group was set up, and comprehensive prevention and control strategies were adopted through multi-department cooperation. At the same time, regular meetings were held to analyze the causes, propose solutions and continuous improvement measures. The effect on prevention and control of MDROs were comprehensively evaluated by analyzing the implementation rate of prevention measures, isolation rate of MDROs on object surfaces, incidence of nosocomial infection and isolation rate of MDROs. RESULTS The total implementation rate of prevention measures for MDROs was increased from 66.59% in 2018 to 91.62% in 2020(P<0.001). The total isolation rate of MDROs on environmental objects surfaces dropped from 8.23% in 2018 to 0.12% in 2020(P<0.001). The total incidence of MDROs nosocomial infection dropped from 0.296% in 2017 to 0.112% in 2020(P<0.001). The total isolation rate of MDROs dropped from 67.24% in 2017 to 25.80% in 2020(P<0.001). CONCLUSION The’informatization plus multidisciplinary cooperation’ management mode boosts health care workers’ execution force on the prevention measures and effectively reduces incidence of MDROs infection and isolation rate among the hospitalized patients.