主动干预模式在提高产科病原学送检质量中的应用效果研究

Application efficacy of active intervention mode in improving the quality of detection of pathogens from department of obstetrics

目的分析主动干预模式在提高产科病原学送检质量中的应用效果。方法选择2022年1月—2023年12月某医院产科治疗性使用抗菌药物的住院患者为研究对象,针对病原学送检率和标本合格率实施主动干预措施,2022年1—12月为干预前阶段,2023年1—12月为干预后阶段。对比分析主动干预前后相关指标,评价干预效果。结果主动干预后产科住院患者治疗性抗菌药物使用率(5.08%)低于干预前(11.87%);抗菌药物治疗前指向性病原学标本送检占比在主动干预后(54.63%)高于主动干预前(8.04%),其中,干预后血培养(24.67%VS 5.15%)、尿培养(4.41%VS 1.65%)、胎膜培养(11.01%VS 0.41%)、宫颈分泌物培养(5.29%VS 0.41%)和羊水培养(9.25%VS 0.41%)占比均较干预前提高,差异均有统计学意义(均P<0.05);主动干预后产科微生物培养送检标本合格率(91.13%)高于主动干预前(66.67%),差异有统计学意义(P<0.001)。结论主动干预模式不仅可以提高医务人员指向性病原学送检的意识,也实现了微生物培养送检合格率的提高,有效提升了产科病原学送检质量。

Objective To analyze the application effect of active intervention mode in improving the quality of detection of pathogens from department of obstetrics.Methods Inpatients receiving therapeutic antimicrobial therapy in the department of obstetrics in a hospital from January 2022 to December 2023 were selected as the research subjects,active intervention measures were implemented based on the pathogen detection rate and specimen qualified rate.January-December 2022 was pre-intervention stage and January-December 2023 was post-intervention stage.Relevant indicators before and after the active intervention were compared and analyzed to evaluate the intervention efficacy.Results Therapeutic antimicrobial use rate in obstetric inpatients after active intervention was lower than before intervention(5.08%vs 11.87%).The proportion of targeted pathogen specimen detection before antimicrobial therapy after active intervention was higher than before active intervention(54.63%vs 8.04%),among which the proportions of blood culture(24.67%vs 5.15%),urine culture(4.41%vs 1.65%),fetal membrane culture(11.01%vs 0.41%),cervical secretion culture(5.29%vs 0.41%),and amniotic fluid culture(9.25%vs 0.41%)after intervention all increased compared with before intervention,and the differences were all statistically significant(all P<0.05).The qualified rate of microbial culture specimens from department of obstetrics after active intervention was higher than before active intervention(91.13%vs 66.67%),with statistically significant difference(P<0.001).Conclusion Active intervention mode not only improve the health care workers’awareness on targeted pathogen detection,but also increase the qualified rate of microbial culture detection,effectively improve the quality of detection of pathogens from department of obstetrics.