Construction of competency evaluation system for infection control personnel in traditional Chinese medicine hospitals

Background:This study uses a literature review and the Delphi expert consultation method to construct a competency evaluation model for infection control personnel in traditional Chinese medicine(TCM)hospitals.The aim is to strengthen infection control management in TCM hospitals,assess the competency of infection control personnel in their positions,and assist them in identifying the competencies that need improvement.Methods:Based on the literature research method and the Delphi expert consultation method,a competency model for the position was constructed through two rounds of expert consultations,analyzing the relationships between various factors and establishing a hierarchical structure model.Pairwise comparisons were made among the elements at the same level to construct a judgment matrix.Through the analytic hierarchy process,the weight coefficients of the indicators at each level in the competency model were obtained.Results:This study conducted a comprehensive assessment of various capabilities and practices related to hospital infection control.The survey results indicate that participants excelled in multiple areas,with a high overall satisfaction rate.95.28%of participants were able to develop hospital infection monitoring plans based on national infection control policies,demonstrating a good understanding and execution of these policies.94.09%of participants were familiar with high-risk populations and key departments in the hospital.91.73%of participants were able to establish monitoring scopes based on the trends of multidrug-resistant bacteria and conduct information monitoring,reflecting strong response capabilities.92.91%of participants were able to collaborate with relevant departments to conduct bacterial resistance monitoring,showing a good team spirit.94.49%of participants were able to perform targeted monitoring,including surgical site infections,indicating that they have effective monitoring strategies.91.34%of participants were able to collect and organize monitoring data and establish a systematic database,demonstrating good data management skills.90.16%of participants were able to interpret laws and regulations related to hospital infection management,indicating a high level of legal knowledge.89.37%of participants generally possessed good communication skills.92.52%of participants were able to guide medical staff on occupational safety and protective knowledge,showing an emphasis on occupational health.Participants demonstrated a strong desire to learn and innovate,with 87.01%actively participating in continuing education and research activities,reflecting a pursuit of professional development.Conclusion:Based on the results of the two rounds of expert consultations,a competency evaluation model for infection control personnel in TCM hospitals was formed.Through the analytic hierarchy process,the weight coefficients of various indicators at different levels in the model were obtained,and the research results have good scientific validity and reliability.

Infection Prevention Strategy in General Hospital under Regular Epidemic Prevention and Control

New coronavirus pneumonia spread rapidly all over the world in the first half of 2020, which is a new respiratory disease with strong infectiousness. At present, the epidemic situation in China has been effectively controlled, but the global epidemic situation remains grim, and the National Health Commission has instructed that the prevention and control of new coronavirus pneumonia should become normalized. As outposts for surveillance of public health events, hospitals are an important front in the fight against the epidemic. Therefore, it is very crucial to construct infection prevention and control system actively to contain the outbreak. This paper analyzes and summarizes the normal prevention and control management strategy of Infection Control Branch Management (hereinafter referred to as Hospital Infection-Control Dept) in a certain designated comprehensive third-grade hospital in Guangdong Province and transforms the prevention and control means in emergency state into measures for sustainable development, which also provides basis and reference for Hospital Infection-Control Dept of medical institutions to formulate prevention and control guidelines.

Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile Osteoporotic Vertebral Compression Fracture during Epidemic Period

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.

The Application of the “3 + 1” Mode in the COVID-19 Epidemic Prevention and Control at the Infection Ward of a Designated Comprehensive Hospital for COVID-19 Treatment

Objective: We assess the application effect of the “3 + 1” mode in the COVID-19 epidemic prevention and control at the infection ward of a designated comprehensive hospital for COVID-19 treatment. Method: Based on the features of the inpatients of the infection ward and their relatives, a “3 + 1” mode for the COVID-19 prevention and control is developed to conform to the demands for epidemic prevention and control and the overall prevention and control scheme of the whole hospital. Here, “3” stands for the epidemic prevention and control system, personnel management, and prevention and control measures;“1” stands for COVID-19 testing. Result: From March 1, 2020 to March 31, 2021, a total of 3056 patients were hospitalized in the three infection wards. Among them, 265 patients had a fever, and 113 patients had respiratory symptoms. None of them were infected with COVID-19. The participation rate of the test about the knowledge related to COVID-19 and the knowledge mastery rate were both 100% among the medical staff. None of the inpatients and their companions or the medical staff was diagnosed with COVID-19. Conclusion: Thus the “3 + 1” mode proves successful for avoiding nosocomial infection and the spread of the epidemic.

Exploration of Infection Prevention and Control Practice of Designated Hospitals in During Corona Virus Disease 2019 Epidemic Period

Corona Virus Disease 2019(COVID-19)is a new infectious disease that appeared in whan in December 2019 Since January23,the national health and fitmess commission has required hospitals to be designated in accordance with the principle of"concentrating patients,experts,resources and treatment".Designated hospitals are often the strength of the general hospital and general hospital complex layers of various kinds of personnel,campus area is large,multi-channel,ordinary outpatient accepts people more,for emergency and severe cases treatment in patients with normal difficulty pressuure big,suspected/confirmed cases,combined with the COVID-19 occurred when the traditional holiday,the country launched the emergency response since,process reform faces a difficult labor,shortage of mampower,protective shortages,short time limit,and many other difficulties,hospital infection prevention and control is facing unprecedented pressure.In this paper,the West China-Guang'an Hospital,Sichuan University(Guang'an people's hospital)as a designated hospital,on the basis of the relevant scheme of the national health committee,epidemic prevention and control of the actual,combined with comprehensive hospital leadership,mampower allocation,protection,security,patient management,disinfection isolation,preview triage,preventive measures,training,monitoring,etc.,with practical experience summary for the COVID-19 diring the hospital infection prevention and control to improve the practice exploration.

Analysis and control of multidrug-resistant bacteria in hospital

Objective:To investigate the status of multidrug-resistant bacteria and the prevention and control measures of nosocomial in-fection in our hospital.Methods:The annual monitoring of multidrug-resistant bacteria infection was measured to summarize the bacteria species,statistical distribution and antibiotic resistance.Identification of multidrug-resistant bacteria infection in patients infected or hospital acquired infections was taken to analyze the reasons of multidrug-resistant bacteria strain and put forward the relevant measures.Results:The top five of multidrug-resistant strains infections were:Gram-positive bacteria including methicillin-resistant Staphylococcus aureus,Staphylococcus aureus;Gram-negative bacteria including Escherichia coli,Acinetobacter bauman-nii,Klebsiella pneumoniae.Conclusions:The occurrence of multidrug-resistant hospital infections could be prevented by rational use of antibiotics,hand hygiene and disinfection management,and reinforced monitoring of multidrug-resistant bacteria.

Jordanian Nurses’ Knowledge of Preventing Surgical Site Infections in Acute Care Settings

Background: Surgical Site Infection (SSI) is one of the most common healthcare-associated infections, its account for up to 16% of all healthcare-associated infections worldwide. The SSIs can contribute to post-operative morbidity, prolonged recovery, delayed discharge and increasing cost. Nurses’ knowledge of the evidence-based recommendations is necessary to provide high-quality nursing care. Aims: To assess the level of Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs, to describe the relationship between nurses’ knowledge and selected sociodemographics, to examine the differences in nurses’ knowledge with respect to selected dichotomized variables, and to identify the most significant predictors of Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs. Design: Cross-sectional design. Sample: Two hundred registered nurses at four targeted hospitals were recruited conveniently. Results: The mean of the total knowledge scores of the sample was 3.28 out of nine (SD = 1.72, range = 0 - 7), the median was 3 out of nine. There were a statistically significant correlation between all tested continuous sociodemographics variables and the total knowledge score (p > 0.05). There is a significant difference in nurses’ knowledge between those who are attending to special surgical related training course and who are not. The most significant predictors of Jordanian nurses’ knowledge were: the number of credit hours attended by nurses for surgical-related training courses and the total years of work experience in nursing. These variables explained 16.7% of variance. Conclusion: The results of this study shed light on the obstacles that hampers the Jordanian nurses’ knowledge regarding evidence based guidelines for the prevention of SSIs in acute care settings. However, the successful implementation of infection control measures, particularly SSIs prevention measures, and well-structured continuing education programs are considered as a substantial element that would improve nurses’ knowledge.

分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响

目的探讨和分析分层次教学培训对护士医院感染防控知识掌握水平及管理质量的影响和改善效果。方法选择安徽医科大学第二附属医院402名护士作为研究对象,于2023年3月1日—7月31日开展分层次教学培训,采用回顾性分析,对是否担任过医院感染管控护士的护士知识掌握程度、培训前后护士医院感染防控知识掌握水平和医院感染管理质量进行比较与分析。结果担任过医院感染管控护士的护士医院感染防控知识掌握评分高于未担任过的护士,差异有统计学意义(P<0.05)。培训后,护士在医院感染管理规范、诊疗器械处理程序、医院感染概念、空气消毒方面的知识掌握评分高于培训前,差异有统计学意义(P<0.05);护士在操作技能、应急能力、理论知识以及消毒管理方面的医院感染管理质量评分高于培训前,差异有统计学意义(P<0.05)。结论分层次教学培训的实施,显著提升了护士的医院感染防控知识掌握水平,同时也改善了医院感染管理质量。

对医护人员实施ICU感染防控管理的效果

目的分析对医护人员实施重症监护病房(intensive care unit,ICU)感染防控管理的效果。方法选取2022年1月—2023年12月在新疆生产建设兵团第九师医院ICU病房工作的21名医护人员作为研究对象,2022年1—12月(对照组)行常规管理,2023年1—12月(观察组)行ICU感染防控管理。对比两组医院感染发生情况与感染控制措施执行评分。结果观察组医护人员医院感染发生率为0,低于对照组的9.52%(2/21)。观察组环境控制评分为(95.43±2.23)分、物品消毒评分为(94.23±1.89)分、无菌操作评分为(95.13±3.87)分、手卫生评分为(95.09±3.92)分,均高于对照组的(90.34±3.14)分、(90.87±2.10)分、(90.11±2.87)分、(90.87±3.88)分,差异有统计学意义(t=7.239、6.514、5.707、4.191,P均<0.05)。结论ICU感染防控措施能有效减少医院感染情况,提高医护人员的感染控制措施执行力。

医学生医院感染防控临床思维能力现状及影响因素研究

目的了解医学院校医学生医院感染防控(以下简称院感防控)临床思维能力现状及存在的问题,为培养医学生院感防控临床思维能力提供依据。方法采取整群抽样法选取某临床医学院长学制实习医学生为调查对象进行问卷调查。结果学习成绩、参加病例讨论频次、对临床思维知识的了解程度、对院感防控临床思维知识的了解程度是医学生院感防控临床思维能力的影响因素。结论医学生院感防控临床思维能力整体较强,批判性思维能力、系统性思维能力等仍需提高。

基于“12345”热线转办的投诉分析及措施探讨

目的归纳总结“12345”热线转办投诉的情况,分析原因,提出处理措施。方法选取2020年1月—2022年12月“12345”热线转办的启东市中医院投诉763件进行分析,分析投诉类型,总结发生投诉的科室分布情况,同时总结引起投诉的相关原因,提出处理措施。结果763件投诉情况中,涉及院感防控方面的总计380件,占比49.80%,其他涉及医院诊疗服务、就医流程、医疗收费等情况。涉及投诉的科室包括门诊医技科室、病区、总务、药房、收费等。分析结果显示,院感防控是3年内引起投诉的主要原因;其次是医患沟通不到位、医疗质量问题、服务态度问题、收费不合理等。结合原因提出相应处理对策。结论通过“12345”热线能够一定程度使医院了解投诉信息,拓宽投诉通道,改进服务机制,提升服务质量,以建立和谐、融洽的医患关系。

ICU护士血管导管相关感染预防与控制知识的现状调查

目的调查重症医学科(intensive care unit,ICU)护士血管导管相关感染(vessel catheter associated infection,VCAI)预防与控制知识的现状,为提高ICU护理质量提供改进依据。方法采用便利抽样方法,选取2022年11—12月厦门大学附属第一医院ICU 60名在职护士作为调查对象。采用一般资料调查表、VCAI预防与控制知识现状调查表和学习情况调查表对其进行调查,并调查2020—2022年ICU的VCAI发生率。结果60名护士VCAI预防与控制知识总得分为10~27分,平均(20.57±3.50)分,平均得分率为76.18%,处于中等水平,各维度知识掌握水平不等。2020年发生1例VCAI,发生率为3.19‰;2021年发生2例VCAI,发生率分别为2.52‰、2.91‰;2022年未发生VCAI。结论ICU护士对VCAI知识掌握程度处于中等水平,应进一步加强对护士相关知识的培训和考核,规范操作流程,提高ICU护理质量。

重症医学科医院感染控制原则专家共识(2024)

重症患者是医院感染的高危人群,且医院感染会显著增加重症患者的死亡率和治疗成本,因此,在治疗原发疾病的过程中,严格防控新发医院感染是重症患者救治的重要组成部分。重症患者的救治涉及多个环节,需从理论、管理、教育、规范、监督等多个层面发挥合力作用,才能实现医院感染的有效防控,但目前医院感染防控尚缺乏统一的认识和规范。为此,2024年3月,国内多名重症医学、感染病学及医院感染相关专家共同探讨了重症医学科医院感染控制现状及其问题,并在参考国内外最新循证医学证据的基础上,形成了《重症医学科医院感染控制原则专家共识(2024)》,以期为重症医学科制订医院感染防控策略提供依据。

基于社会网络分析法的方舱医院感染防控风险问题识别及策略分析

目的 筛选我国方舱医院感染防控实践存在的风险问题,为健全方舱医院感染防控体系提供参考。方法 以中国知网检索文献中提炼出29个方舱医院感染防控风险问题为依据,运用社会网络分析法对方舱医院感染防控风险问题网络从网络密度、点度中心度、中间中心度三个角度进行分析。结果 方舱医院感染防控风险问题网络交互度不高(0.393),社会网络点度中心度排名前3位的节点为缺乏可供参考的感染管理模式(23.00)、基于大型体育馆改建三区两通道设计不合规范(23.00)、第三方工作人员基本感染防控知识不足(23.00),中间中心度排名前3的节点为基于大型体育馆改建三区两通道设计不合规定(142.245)、专业化感染防控培训不足(51.625),第三方工作人员基本感染防控知识不足(49.595),主要位置节点重复表明未来该领域的研究趋向。结论 方舱医院感染防控受到多方面风险因素掣肘,强化方舱医院感染防控内部结构建设与感染防控运行质量,是方舱医院感染防控领域亟待解决的热点问题。

“木桶理论”在某三甲医院遏制多重耐药菌感染防控工作中的应用

多重耐药菌感染防控已成为医院高质量发展的重要任务,亦是目前医院感染防控所面临的主要挑战之一。为遏制多重耐药菌传播、降低医院感染发生率,本研究于2022年12月1日—2023年11月30日在某三甲医院采用“新木桶理论”管理工具构建了项目主架构,通过夯实制度管理桶底、固化监测系统长板、补齐科研创新短板、消除多部门间缝隙、优化绩效考核以及强化院级支持,充分发挥每一块“木板”的优势,总结出了一套行之有效的工作方案,以期更好地提升多重耐药菌感染管理工作质量,为医院多重耐药菌感染防控工作提供参考。

精细化管理在结直肠癌患者手术部位感染防控中的探索与实践

目的探讨运用精细化管理策略,在结直肠癌患者手术部位感染(SSI)防控的应用价值及实践效果。方法由医院感染管理科牵头运用精细化管理策略,在广西医科大学附属肿瘤医院开展基于精细化管理的结直肠癌患者SSI防控实践,2020年7月至2023年6月在该院实施医院感染精细化管理后,通过比较该院结直肠癌患者的SSI发生情况,来评价精细化管理的实施效果。结果实施医院感染精细化管理后,2020年7月至2023年6月,接受手术治疗的结直肠癌患者的SSI发生率为1.68%,且呈逐年下降趋势,差异有统计学意义(P<0.05)。按结肠癌根治术、直肠癌根治术及其他肠道手术分类,其中结肠癌根治术的SSI发生率逐年下降,差异有统计学意义(P<0.05)。发生吻合口瘘为SSI最主要的感染原因(71.74%)。SSI检出病原菌中,大肠埃希菌检出率最高(62.16%)。结论运用精细化管理方法,将临床学科与感控学科交叉融合,多项举措并施为患者创造更优的围手术期条件,可进一步降低结直肠癌患者SSI发生率,提高医疗质量、保障医疗安全,助力公立医院高质量发展。

重症医学科医院感染困境与破局

随着重症医学的不断发展,重症医学科的医院感染问题日益突显,进而造成了诸多严重不良后果。因此,厘清其关键环节及发生机制,探讨更合理和有效的体系化防控手段,对于减少重症医学科医院感染、降低救治成本、改善患者预后具有重要意义。除体系化防控措施外,还需通过多学科通力协作及行政部门的大力支持,严格落实医院感染防控的具体细节,才能使这一棘手问题得以妥善解决。

规范化护理管理在预防与控制医院感染中的应用

目的研究分析规范化护理管理在预防与控制医院感染中的应用效果。方法将100例在我院接受治疗的患者选为研究对象,时间选取范围为2021年3月至2022年3月,按照双盲法将患者分成两组,即参照组与观察组,每组患者各50例。参照组给予常规护理管理,观察组给予规范化护理管理,对两组医院感染发生率、心理状态、健康知识掌握情况、自护能力、护理满意度予以观察比较。结果相比于参照组,观察组医院感染发生率更低,组间具有统计学意义(P<0.05)。在护理后,观察组心理状态各指标评分低于参照组(P<0.05)。观察组护理后医院感染知识、疾病知识、治疗与康复知识、护理管理知识评分高于参照组(P<0.05)。与参照组相比,观察组护理后自我概念、自护技能、自护责任感、健康知识评分更高,组间具有统计学意义(P<0.05)。针对护理满意度而言,观察组高于参照组(P<0.05)。结论规范化护理管理在预防与控制医院感染中的应用效果十分明显,能够有效降低医院感染发生率,改善患者心理状态,增加患者对健康知识的了解,提高患者自护能力与护理满意度,具有非常高的应用价值。

某市三甲医院2020—2022年医院感染调查与分析

目的回顾调查清远市人民医院2020年1月—2022年12月医院感染的基本情况,分析该院医院感染现状,并对此提出有效的院感防控措施。方法采取回顾性调查方法,选取清远市人民医院2020年1月—2022年12月医院感染相关数据进行统计分析。结果2020、2021、2022年感染例次分别为875、611、304例次,例次感染率分别为1.13%、0.71%、0.38%,总例次感染率为0.73%;医院感染率分别为1.05%、0.66%、0.36%,3年间比较差异有统计学意义(P<0.001)。感染部位以下呼吸道感染构成比最高,其次为泌尿系统感染、上呼吸道感染。2020、2021年医院感染发生率最高的科室依次为重症医学科、脑科病区、骨科病区,2022年医院感染发生率最高的科室依次为脑科病区、重症医学科、妇科病区。检出病原菌897株,以革兰阴性菌为主,构成比为62.99%。结论该院2020—2022年住院患者医院感染率在控制指标范围内,虽然较低,但仍应加强对高发科室的目标性监测、高危人群的预防及医护人员的相关培训以控制医院感染的发生。