基于追踪方法学的管理策略在医院人工气道多重耐药菌感染防控中的应用

Application of Management Strategy Based on Tracking Methodology in the Prevention and Control of Multi Drug Resistant Bacterial Infection in Hospital Artificial Airway

目的:探讨基于追踪方法学的管理策略在医院人工气道多重耐药菌(MDRO)感染防控中的应用效果。方法:回顾性分析2017年1月—2021年1月于南阳市第二人民医院留置人工气道的158例患者及其所接触161名医护人员追踪资料,将开展基于追踪方法学的管理策略前(2017年1月—2019年6月)入院者纳入对照组(患者80例,医护人员82名),开展后(2019年7月—2021年1月)入院者纳入观察组(患者78例,医护人员79名)。分析两组患者MDRO感染率及追踪全程指标合格情况,评估两组MDRO感染患者控制措施执行情况。结果:追踪后各指标合格数显著高于对照组,差异有统计学意义(χ2=4.065、4.398、4.533、4.208、5.505,P<0.05);观察组MDRO隔离医嘱执行率、消毒隔离执行率及抗菌药物合理使用率比较差异无统计学意义(P>0.05);MDRO检出率显著低于对照组,差异有统计学意义(χ2=12.233、14.378,P<0.05)。结论:基于追踪方法学的管理策略能够提高医院人工气道MDRO感染防控执行力,降低MDRO感染率。

Objective:To explore the effectiveness of management strategies based on tracking methodology in the prevention and control of multi-drug resistant organisms(MDRO)infections in the hospital artificial airway.Methods:The data of 158 pa⁃tients with an indwelling artificial airway in the hospital and the 161 medical and nursing staff they contacted for follow-up from January 2017 to January 2021 were retrospectively analyzed.Those admitted to the hospital before(January 2017 to June 2019)and after(July 2019 to January 2021)carrying out the management strategy based on the tracking methodology were included in the control group(80 patients and 82 medical and nursing staff)and in the observation group(78 patients and 79 medical and nursing staff).The rate of MDRO infections and the passing of indicators throughout the follow-up were analyzed in both groups,and the implementation of control measures in patients with MDRO infections was assessed in both groups.Results:The number of passing indicators after follow-up was significantly higher than that of the control group,with statistically significant differences(χ2=4.065,4.398,4.533,4.208,5.505,P<0.05).There was no statistically significant difference in the implementation rate of MDRO isolation medical orders,sterilization isolation implementation rate and rational use rate of antibacterial drugs in the observation group(P>0.05).The MDRO detection rate was significantly lower than that of the control group,and the difference was statistically signifi⁃cant(χ2=12.233,14.378,P<0.05).Conclusion:Management strategies based on tracking methodology can improve the execution of MDRO infection prevention and control in the hospital artificial airway and reduce MDRO infection rates.