摘要
目的构建ICU系统风险管理模式,明确医院感染防控重点,提高资源利用效率,以降低医院感染发病率。方法通过构建ICU系统风险管理模式,筛选出极高风险ICU,针对极高风险ICU二次评估,筛选高风险环节进行干预,比较干预前后医院感染发病率、医院感染多药耐药菌千日发现率等指标。结果神经内科ICU风险最高,对其进行二次评估,筛选出高风险环节针对性进行干预,风险评估项目实施后,干预前、后患者的年龄、性别、糖尿病及高血压等一般资料比较,差异均无统计学意义。医院感染例次发病率由23.26%(20/86)降低到9.82%(11/112)(P<0.05),医院感染MDRO发生率由5.29‰(6/1135)降低到0.94‰(1/1069)(P<0.05),人均住院天数由13.20(1135/86)天降低到9.54(1069/112)天。结论构建ICU系统风险管理模式,评估出高风险部门及高风险环节,针对性进行干预,有效优化资源配置,降低医院感染的发生,确保医患安全。
OBJUECTIVE To construct the risk management model of ICU system,clarify the key points of prevention and control of nosocomial infection,and improve the efficiency of resource utilization,reduce the incidence of healthcare-associated infection(HAI).METHODS By constructing the risk management model of ICU system,the extremely high-risk ICU was screened out.Aiming at the secondary assessment of extremely high risk ICU,the high risk processes were selected for intervention,and the incidence of nosocomial infection and the detection rate of multidrug resistant bacteria in nosocomial infection were compared before and after intervention.RESULTS The neurology ICU had the highest risk,and it was evaluated for two times.The high-risk process was selected out for further intervention.After the implementation of risk assessment,there was no significant difference in age,gender,diabetes and hypertension between before and after intervention.The incidence of HAI significantly decreased from 23.26%(20/86)to 9.82%(11/112)(P<0.05).The incidence rate of MDRO in HAI decreased from 5.29‰(6/1135)to 0.94‰(1/1069)(P<0.05),and the average per capita hospitalization days decreased from 13.20(1135/86)to 9.54(1069/112)days.CONCLUTIONThe construction of the risk management model of ICU system,evaluation of high-risk departments and high-risk processes,and targeted interventions can effectively optimize the allocation of resources,reduce the occurrence of HAI and ensure the safety of doctors and patients.
作者
杨廷秀
徐艳
杨怀
贺玲
刘丽娟
李肖
郝劲博
蒋丽娜
YANG Ting-xiu;XU Yan;YANG Huai;HE Ling;LIU Li-juan;LI Xiao;HAO Jin-bo;JIANG Li-na(Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550002,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第20期3166-3169,3195,共5页
Chinese Journal of Nosocomiology
基金
黔科合基础基金资助项目([2016]1509号)
关键词
ICU系统
风险管理
模式
医院感染
发病率
ICU system
Risk management
Model
Nosocomial infection
Incidence
作者简介
通讯作者:徐艳,E-mail:xywsw@163.com。
