“提高住院患者抗菌药物治疗前病原学送检率”专项行动开展现况调查

Survey of implentation of"raising etiological submission rate of hospitalized patients before antimicrobial treatment"

目的 通过问卷调查,了解我国哨点医院在提高住院患者抗菌药物治疗前病原学送检率管理方面的现状。方法 结合“国家医院感染管理专业质控中心哨点医院信息上报系统”发布的两次网络问卷结果,通过Excel、SPSS制作综合表格比对分析。结果 专项行动实施后,495家医院中,有224(45.25%)家医院增加了感控专职人员数量;415(83.84%)家医院新增了专项行动工作小组、制度及方案。专项行动实施后,将绩效考核纳入考核指标的医院所占比例由60.61%上升至73.13%(P<0.05)、未纳入相关考核指标的医院所占比例由11.52%降为7.68%(P<0.05)。专项行动实施后,影响医疗机构改进目标专项行动因素中医务人员送检意识不足所占比例由83.23%降为78.38%(P<0.05)、医务人员相关理论知识掌握不足所占比例由63.23%降为56.77%(P<0.05)、未制定考核方案所占比例由24.65%降为13.74%(P<0.05)、未制定相关制度所占比例由18.99%降为8.69%(P<0.05);不同级别医院间比较显示,三级医院与非三级医院间仅有医务人员相关理论知识掌握不足所占比例变化有统计学意义(P<0.05)。结论 专项行动促使各医疗机构增加了相关专职人员数量,医院相关组织、制度、考核、培训情况均有所改善,医院病原学送检率管理有了很大的提升。

OBJECTIVE To understand the current stratus of management of"raising etiological submission rate of hospitalized patients before antimicrobial treatment"in Chinese sentinel hospitals by means of questionnaire sur-vey.METHODS The results of two times of online questionnaires were released from the Sentinel Hospital Infor-mation Reporting System of the Quality Control Center of National Hospital Infection Management.Excel and SPSS were used to make comprehensive tables for comparison and analysis.RESULTS After the special action was carried out,224 of 495(45.25%)hospitals have increased the number of full-time infection control personnel,415(83.84%)added the work groups,systems and plans for the special action.The proportion of the hospitals that brought the performance assessment into the assessment indexes was increased from 60.61%to 73.13%(P<0.05);the proportion of the hospitals that did not bring the performance assessment into the assessment indexes was decreased from 11.52%to 7.68%.Among the factors that affected the improvement of target special action,the proportion of poor awareness of submission of health care workers was decrease from 83.23%to 78.38%(P<0.05),the proportion of poor acquisition of relevant theoretical knowledge dropped from 63.23%to 56.77%(P<0.05);the proportion of no assessment programs was decreased from 24.65%to 13.74%(P<0.05);the propor-tion of no relevant systems dropped from 18.99%to 8.69%.There was significant difference in the proportion of poor awareness of related theoretical knowledge of health care workers between the tertiary hospitals and the non-tertiary hospitals(P<0.05).CONCLUSION The special action has prompted the medical institutions to increase the number of full-time personnel,improve the organization,system,assessment and training,and remarkably raise the etiological submission rate.