细节管理与全过程督导在多重耐药菌管理中的应用

Application of details management and whole-process supervision mode in the management of multiple drug resistant bacteria

目的为提高管理人员防控管理能力,降低医院感染的发生率,对细节管理与全过程督导模式在多重耐药菌(MDRO)防控管理的效果进行分析。方法选取2019年1—12月实行管理前滕州市中心人民医院收治的326例患者,另选2020年1—12月实行管理后收治的352例患者,其中管理前实施常规MDRO感染预防和控制措施,管理后运用细节管理与全过程督导管理方法。比较管理前后管理方法对MDRO防控管理效果。结果管理前MDRO临床督导执行率为81.6%,管理后MDRO临床督导执行率为88.9%。管理后MDRO发现率为0.34%,高于管理前的0.26%,差异有统计学意义(χ^(2)=4.715,P<0.05)。管理后MDRO检出率为13.64%,高于管理前的10.12%,差异有统计学意义(χ^(2)=19.670,P<0.05)。管理后耐碳青酶烯酶铜绿假单胞菌(CRPAE)检出率为5.84%,高于管理前的3.50%,差异有统计学意义(χ^(2)=4.253,P<0.05)。管理后MDRO医院感染率为0.28%,低于管理前的0.67%,差异有统计学意义(χ^(2)=5.747,P<0.05)。结论将细节管理与全过程督导模式用于MDRO防控管理中,有助于提高管理人员防控管理能力,降低医院感染发生率,对减少MDRO院内感染事件发生有一定的临床应用价值。

Objective In order to improve the prevention and control management ability of managers and reduce the incidence of hospital infection,the effect of details management and whole-process supervision mode on the prevention and control management of multiple drug resistant bacteria(MDRO)was analyzed.Methods A total of 326 patients admitted to Tengzhou Central People's Hospital from January to December2019 before the implementation of management were selected.Another 352 patients admitted after management from January to December 2020 were selected.Before management,routine MDRO infection prevention and control measures were implemented,and after management,details management and whole-process supervision management were applied.The effects of two management methods on the prevention and control of MDRO were compared.Results The rate of clinical supervision and implementation of MDRO before management was 81.6%,and the rate of clinical supervision and implementation of MDRO after management was 88.9%.After management,the discovery rate of MDRO was 0.34%,which was higher than that before management with 0.26%,and the difference was statistically significant(χ^(2)=4.715,P<0.05).After management,the detection rate of MDRO was 13.64%,which was higher than 10.12%before management,and the difference was statistically significant(χ^(2)=19.670,P<0.05).After management,the detection rate of Carbonase resistant Pseudomonas aeruginosa(CRPAE)was5.84%,which was higher than 3.50%before management,and the difference was statistically significant(χ^(2)=4.253,P<0.05).After management,the hospital infection rate of MDRO was 0.28%,which was lower than that before management with 0.67%,and the difference was statistically significant(χ^(2)=5.747,P<0.05).Conclusion The details management and whole-process supervision mode were applied to the prevention and control management of MDRO,which was help to improve the prevention and control management ability of managers,reduce the incidence of hospital infection.It had certain clinical application value to reduce the occurrence of hospital infection of MDRO.