改良预警评分标识联合精细化管理在PIVAS感染防控中的应用

The Application of Improved Warning Scoring Identification Combined With Refined Management in PIVAS Infection Prevention and Control

目的探究改良预警评分标识联合精细化管理模式在静脉用药调配中心(pharmacy intravenous admixture service,PIVAS)感染防控中的应用效果。方法回顾性分析2021年1月—2023年2月经南华大学附属第二医院内PIVAS调配药物的患者相关资料,以2021年1月—2022年1月随机抽取的500例患者作为对照组,以2022年2月—2023年2月PIVAS随机抽取的500例患者作为研究组。对照组进行常规管理模式,研究组进行改良预警评分标识联合精细化管理模式。分析2组不合理用药发生率、输液反应发生率、感染发生率的差异;探究PIVAS相关物品及空气质量的差异;比较配置人员手卫生的差异;比较医院综合ICU三管的感染率与同级别医院综合ICU三管的感染率的差异。结果研究组不合理用药发生率(8.00%vs.14.40%)、输液反应发生率(12.40%vs.19.00%)、感染发生率(6.40%vs.12.60%)均低于对照组(P<0.05)。研究组小型物体表面(100%vs.83.33%)、水平层流台表面(100%vs.95.83%)、生物安全柜表面(100%vs.93.83%)、Ⅰ更衣室空气沉降(100%vs.88.10%)、Ⅱ更衣室空气沉降卫生检测的合格率(100%vs.82.14%)均高于对照组(P<0.05)。研究组配置人员手卫生的卫生检测合格率(100%vs.82.14%)高于对照组(P<0.05)。南华大学附属第二医院综合ICU血管导管相关血流感染发病率(1.55%vs.2.64%)、呼吸机相关肺炎发病率(18.94%vs.23.05%)、导尿管相关泌尿系感染发病率(1.11%vs.1.95%)均低于同级别医院(P<0.05)。结论将基于改良预警评分管理标识的精细化管理模式应用于PIVAS医院感染防控中,能有效避免不合理用药、输液反应及感染发生,降低综合ICU三管的感染率并提升科室相关物品及空气质量、提高配置人员手卫生的检测合格率。

Objective To explore the application effect of improved warning scoring and labeling combined with refined management mode in infection prevention and control of intravenous admixture service(PIVAS).Methods A retrospective analysis was conducted on the relevant data of patients who received PIVAS dispensing drugs at the Second Affiliated Hospital of South China University from January 2021 to February 2023.A total of 500 patients randomly selected from January 2021 to January 2022 were used as the control group,and 500 patients randomly selected from PIVAS from February 2022 to February 2023 were used as the study group.The control group underwent routine management mode,while the research group underwent improved early warning scoring and identification combined with refined management mode.The differences in the incidence of irrational medication,infusion reactions,and infections between the two groups were analyzed.The differences in PIVAS related items and air quality were explored.The differences in hand hygiene of personnel allocation were compared.The difference in infection rates between the three tubes in our hospital's comprehensive ICU and those in the same level of hospital's comprehensive ICU were compared.Results The incidence of irrational drug use(8.00%vs.14.40%),infusion reaction(12.40%vs.19.00%),and infection(6.40%vs.12.60%)in the study group were all lower than those in the control group(P<0.05).The qualified rates of hygiene testing for small object surfaces(100%vs.83.33%),horizontal laminar flow table surfaces(100%vs.95.83%),biosafety cabinet surfaces(100%vs.93.83%),air settling in changing room I(100%vs.88.10%),and air settling in changing roomⅡ(100%vs.82.14%)in the research group were all higher than those in the control group(P<0.05).The qualified rate of hand hygiene testing in the research group(100%vs.82.14%)was higher than that in the control group(P<0.05).The incidence rate of catheter-related bloodstream infection(1.55%vs.2.64%),the incidence rate of ventilator-associated pneumonia(18.94%vs.23.05%),and the incidence rate of catheter related urinary tract infection(1.11%vs.1.95%)in the comprehensive ICU of the Second Affiliated Hospital of South China University were lower than those in the same level hospitals(P<0.05).Conclusion The application of a refined management model based on improved early warning scoring management labels in PIVAS hospital infection prevention and control can effectively avoid unreasonable medication,infusion reactions,and infections,reduce the infection rate of the three pipes in the comprehensive ICU,and improve the testing qualification rate of relevant items and air quality in the department,as well as the hand hygiene of personnel.