标准操作规程对新生儿监护病房医院感染的干预效果研究

Study on the intervention effects of standard operating procedures for nosocomial infection in the neonatal intensive care unit

目的探讨标准操作规程(standard operating procedures,SOP)对新生儿监护病房(neonatal intensive care unit,NICU)医院感染的干预效果,为其临床推广实施提供依据。方法选取某三甲医院2013年1~12月间经SOP干预的NICU患儿为对象(干预组),同时以2011年1~12月未经SOP干预的NICU患儿为对照(对照组),回顾性病例调查,调查资料用SPSS 13.0软件统计分析。结果两组新生儿在胎龄、体重、手术、输液、胸穿、基础疾病、呼吸机及肺泡表面活性物质的使用等医院感染相关危险因素间的差异均无统计学意义(均有P>0.05)。干预组1 151例患儿中,25人发生医院感染,感染率为2.17%,而对照组880例患儿中,84人发生医院感染,感染率为9.54%,干预组医院感染发生率下降(2=56.96,P<0.05);对照组日医院感染率为7.2‰,干预组日医院感染率为1.8‰,两组间的差异有统计学意义(Z=6.64,P<0.05);对照组平均住院床日数为(13.19±4.98)d,干预组平均住院床日数为(11.99±3.72)d,干预后平均住院床日数下降(t=2.39,P<0.05)。结论 SOP的实施显著降低新生儿医院感染率,缩短住院时间,值得在临床上推广使用。

Objective To explore the effects of standard operating procedures( SOP) on nosocomial infection control and prevention in hospital infection in the neonatal intensive care unit( NICU),in order to provide a theoretical basis to widely use it in clinic. Methods Children patients in NICU of neonatology department from January to December in our hospital in 2013,who were intervened by the SOP,were selected as the intervention group. The patients in the NICU from January to December in 2011 without SOP intervention were selected as the control group. Retrospective case investigati on method was used and SPSS 13. 0 software was used for statistical analysis. Results There was no significant difference between experiment group and control group in weight,surgery transfusion,thoracentesis,the use of breathing machine and alveolar surface active substance( all P > 0. 05). There were 84 nosocomial infection patients among 880 cases in 2011,the infection rate was 9. 54%. However there were only 25 nosocomial infection patients in 1 151 cases in 2013,the infection rate was 2. 17%. The infection rate was significantly lowed( 2= 56. 96,P < 0. 05). Similarly,the daily infection rate in 2011 was 7. 2‰ and decreased significantly to only 1. 8‰ in 2013( Z = 6. 64,P < 0. 05). At the same time,the average days of hospitalization was( 13. 19 ± 4. 98) in 2011 while that was( 11. 99 ± 3. 72) in 2013. Average days of hospitalization also decreased( t = 2. 39,P < 0. 05). Conclusions Implementation of the SOP can effectively reduce the neonatal hospital infection rate in the NICU,shorten hospitalization duration,and is effective in clinic.