规范ICU多重耐药菌感染病人接触隔离的循证护理实践

Standardize contact isolation of patients infected with multidrug-resistant bacteria in ICU:an evidence-based nursing practice

目的:提高重症监护病房(ICU)医护人员接触隔离管理水平及最佳证据执行能力,降低ICU多重耐药菌医院感染发生率。方法:运用循证护理方法获取最佳证据,制定多重耐药菌感染病人接触隔离管理审查指标并用于临床进行持续质量改进,比较证据应用前后ICU多重耐药菌医院感染发生率、医护人员对多重耐药菌感染病人接触隔离相关知识知晓情况及执行情况。结果:本研究形成21条质量审查指标,应用最佳证据后,ICU医护人员多重耐药菌接触隔离理论知识评分由(73.49±6.50)分提高到(92.88±6.27)分;接触隔离措施依从性大幅提升,13条审查指标执行率提升至88%以上,差异均有统计学意义(P<0.05),ICU多重耐药菌医院感染率从3.2%降低至1.9%。结论:将基于循证的最佳证据应用于临床,有助于推进ICU多重耐药菌感染病人接触隔离管控措施落实,提升医护人员理论知识及实践水平,降低ICU多重耐药菌医院感染发生率。

Objective:To improve the contact isolation management level and best evidence implementation ability of medical staff in intensive care units(ICUs)and reduce the incidence of multidrug-resistant bacteria hospital infection in ICUs.Methods:Evidence-based nursing methods were used to obtain the best evidence,and the review indicators for contact isolation management of patients with multidrug-resistant bacteria were formulated and used for continuous quality improvement in clinical practice.The incidence of multidrug-resistant bacteria hospital infection in ICUs before and after the application of evidence and the knowledge and implementation of medical staff on contact isolation of patients with multidrug-resistant bacteria were compared.Results:A total of 21 quality review indicators were formulated in this study.After applying the best evidence,the theoretical knowledge score of multidrug-resistant bacteria contact isolation of ICU medical staff increased from(73.49±6.50)points to(92.88±6.27)points.The compliance with contact isolation measures was greatly improved,and the implementation rate of 13 review indicators increased to more than 88%,with statistically significant differences(P<0.05).The infection rate of multidrug-resistant bacteria hospital in ICU decreased from 3.2%to 1.9%.Conclusions:Applying the best evidence based on evidence in clinical practice will help promote the implementation of contact isolation control measures for patients infected with multidrug-resistant bacteria in the ICU,improve the theoretical knowledge and practical level of medical staff,and reduce the incidence of multidrug-resistant bacteria hospital infection in the ICU.