医院感染实时监测系统在医院感染管理中的应用效果

Application Effect of Real-time Monitoring System of Nosocomial Infection in Nosocomial Infection Management

目的 探讨医院感染实时监测系统在医院感染管理中的应用效果。方法 回顾性选择2020年5月—2021年12月深圳市龙华区中心医院ICU重症患者192例为对象,根据时间节点分为对照组(n=96,2020年5月—2021年2月)和观察组(n=96,2021年3—12月),本项目中共涉及医护人员52名。对照组采用院感专职人员人工监测,观察组联合杏林医院感染实时监测系统,比较两组患者导尿管相关尿路感染发生率、感染漏报率、病原菌分离情况、医护人员的院感管理质量及管理合格率。结果 观察组患者干预1、3 d导尿管相关尿路感染率低于对照组,差异有统计学意义(P <0.05);观察组干预1、3、7 d后感染漏报率低于对照组,差异有统计学意义(P <0.05);两组干预7 d后合计感染病例17例,并完成病原菌分离培养,结果表明:观察组分离的优势菌以大肠埃希氏菌为主(共11株)与对照组15株比较差异无统计学意义(P> 0.05);观察组干预7 d后医护人员在院感规章制度流程健全、院感管理制度落实、院感控制知识掌握及成立院感管理工作小组方面的评分均高于对照组,差异有统计学意义(P <0.05)。观察组干预7 d后医护人员在手卫生、环境清洁消毒、医疗废物管理、呼吸机相关性肺炎(ventilator associated pneumonia,VAP)核心防控、导管相关血流感染(catheter related blood stream infection,CRBSI)核心防控及多重耐药菌防控方面的合格率均高于对照组,差异有统计学意义(P <0.05)。结论 医院感染实时监测系统用于医院感染管理中,可降低导尿管相关尿路感染发生率、感染漏报率,分离病原菌主要以大肠埃希氏菌为主,提升医护人员院感管理质量及合格率。

Objective To explore the application effect of real-time monitoring system of nosocomial infection in nosocomial infection management.Methods A total of 192 critically ill patients in Longhua District Central Hospital of Shenzhen’s ICU from May 2020 to December 2021 were retrospectively selected and divided into the control group(n=96,May 2020-February 2021) and the observation group(n=96,March-December 2021) according to time nodes.A total of 52 medical staff were involved in this project.The control group was manually monitored by full-time staff for hospital infection,and the observation group was combined with the Xinglin hospital infection real-time monitoring system to compare the incidence of catheterrelated urinary tract infection,the infection missed rate,the isolation of pathogens,the quality of hospital infection management and management pass rate by medical staff between the two groups.Results The urinary catheter-related urinary tract infection rate in the observation group was lower than control group on the 1st and 3rd day of intervention,the differences were statistically significant(P 0.05).After 7 days of intervention,the scores of medical staff in the observation group on the improvement of hospital infection rules and regulations,the implementation of the hospital infection management system,the mastery of hospital infection control knowledge,and the establishment of hospital infection management working groups were all higher than control group,the differences were statistically significant(P < 0.05).After 7 days of intervention,the qualified rates of medical staff in the observation group in terms of hand hygiene,environmental cleaning and disinfection,medical waste management,ventilator associated pneumonia(VAP) core prevention and control,catheter related blood stream infection(CRBSI) core prevention and control,and multidrug-resistant bacteria prevention and control were all higher than control group,the differences were statistically significant(P < 0.05).Conclusion The real-time monitoring system of nosocomial infection is used in the management of nosocomial infection,which can reduce the incidence of catheter-related urinary tract infection and the underreporting rate of infection.The main pathogens were Escherichia coli,which improved the quality of hospital perception management and qualified rate of medical staff.