基于三维质量结构模型的管理模式对重症监护室多重耐药菌感染的防控效果

Model on Prevention and Control of Multidrug-Resistant Bacteria Infections in Intensive Care Units

目的探究基于三维质量结构模型的管理模式的应用对重症监护室(ICU)多重耐药菌感染的防控效果。方法采用回顾性研究,收集郑州市第一人民医院ICU收治的100例患者资料,将2020年1-8月接受常规管理模式的50例患者资料归为常规组,将2020年9月至2022年9月接受常规管理模式联合基于三维质量结构模型的管理模式的50例患者资料归为管理组,两组患者均连续接受管理14 d。由研究者设计资料调查表,详细收集患者一般资料,并收集两组患者多重耐药菌感染情况及抗菌药物使用强度、使用率,同时比较两组患者ICU治疗时间、总住院时间及对质量管理工作满意度。结果管理组抗药性金黄色葡萄球菌(MRSA)感染率、超广谱β-内酰胺酶的大肠埃希菌(ESBLs-ECO)感染率、超广谱β-内酰胺酶的肺炎克雷伯菌(ESBLs-KPN)感染率、抗菌药物使用强度及使用率均低于常规组,差异有统计学意义(P<0.05);管理组ICU治疗时间及总住院时间均短于常规组,差异有统计学意义(P<0.05);两组患者对质量管理工作满意度对比,管理组高于常规组,差异有统计学意义(P<0.05)。结论应用基于三维质量结构模型的管理模式可有效改善ICU患者多重耐药菌感染情况,减少抗菌药物的使用并缩短ICU治疗时间及住院时间,且能够提高患者对质量管理工作满意度。

Objective To explore the effectiveness of the application of a management model based on a three-dimensional quality structure model in the prevention and control of multidrug-resistant bacteria infections in intensive care unit(ICU).Methods A retrospective study was conducted to collect data from 100 patients admitted to the ICU of the First People’s Hospital of Zhengzhou.The data of 50 patients who received conventional management mode from January to August 2020 were classified as the conventional group,and the data of 50 patients who received conventional management mode and management mode based on three-dimensional quality structure model from September 2020 to September 2022 were classified as the management group.Both groups of patients received continuous management for 14 days.The baseline data questionnaire was designed by the researchers,and the general data of the patients were collected in detail.Multidrug-resistant bacteria infection and the use intensity and utilization rate of antibiotics in the two groups were collected.At the same time,the ICU treatment time,total hospitalization time and satisfaction with quality management were compared between the two groups.Results The infection rate of drug-resistant Staphylococcus aureus(MRSA),extended-spectrumβ-lactamase Escherichia coli(ESBLs-ECO),extended-spectrumβ-lactamase Klebsiella pneumoniae(ESBLs-KPN),the use intensity and use rate of antibacterial drugs in the management group were lower than those in the conventional group,with a statistically significant difference(P<0.05).The ICU treatment time and total hospitalization time in the management group were shorter than those in the conventional group,with a statistically significant difference(P<0.05).The satisfaction degree of patients in the management group was higher than that in the conventional group,with a statistically significant difference(P<0.05).Conclusion The application of a management model based on a three-dimensional quality structure model can effectively improve the infection of multidrug-resistant bacteria in ICU patients,reduce the use of antibacterial drugs,shorten the treatment time and hospitalization time in ICU,and improve patient satisfaction with quality management.