武汉市医疗机构发热门诊医院感染管理现状调查

Current situation of healthcare-associated infection management of fever clinics in Wuhan medical institutions

目的 分析武汉市不同级别医疗机构发热门诊的医院感染管理情况,为进一步提高医院感染管理水平提供科学依据。方法 2023年1月对武汉市设置发热门诊的医疗机构进行网络问卷调查。结果 72所医疗机构中,发热门诊CT配置率为58.33%,48.61%设置有儿童发热诊室。医院感染管理总合格率为78.28%,医院管理、诊疗环境保障、培训宣教和感控措施落实等4个一级指标,合格率分别为82.27%、71.49%、75.93%和81.31%,不同级别医疗机构间差异有统计学意义(均P<0.01)。13个二级指标中7个合格率>80%,最高是医用物品管理(93.06%)、医废处置(89.72%)和人员管理(83.33%),最低是设施设备(66.32%)、患者及陪同人员宣教(66.67%)。65个三级指标中30个合格率>80.00%。结论 武汉市积极推进发热门诊建设,医院感染管理质量整体较好,但仍不同程度存在一些问题,尤其是二级及以下医疗机构的发热门诊在布局流程、手卫生、工作人员培训等方面应进一步加强。

Objective To analyze the current situation of healthcare-associated infection(HCAI) management of fever clinics among different levels of medical institutions in Wuhan,and to provide a scientific basis for improving hospital infection management.Methods In January 2023,a network questionnaire survey was conducted on medical institutions with fever clinics in Wuhan.Results A total of 72 medical institutions were investigated,of which 58.33% had CT infever clinics,and 48.61% had fever clinics for children.The total qualified rate of HCAI management was 78.28%.The qualified rates of four primary indicators,including hospital management,diagnosis and treatment environment protection,training and education,and implementation of infection control measures,were 82.27%,71.49%,75.93%,and 81.31%,respectively.There were statistical differences among different levels of medical institutions(all P<0.01).Among the 13 secondary indicators,the qualified rates of 7 indicators were more than 80%,with the highest being medical item management(93.06%),medical waste disposal(89.72%),and personnel management(83.33%),and the lowest being facilities and equipment(66.32%),and patients and accompanying personnel education(66.67%).Among the 65 tertiary indicators,30 had a pass rate great than 80%.Conclusion Wuhan actively promotes the construction of fever clinics in medical institutions,and the overall situation of HCAI management is good.However,there are still some problems to varying degrees,especially in the layout procedures,hand hygiene,and staff training of fever clinics in secondary and lower medical institutions,which should be further strengthened.