医疗机构每年开展现患率调查的辩证思考
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摘要
通过上海国际医院感染控制论坛(Shanghai international forum for infection control and prevention,SIFIC)组织探讨在医疗机构内部每年开展现患率调查的必要性。一方面从我国颁布的《医院感染管理办法》等要求及开展现患率的优点,如省时,省力,获得更全面的数据分析结果,多部门协作,体现感控工作的联动性为主要观点,认为每年应开展现患率调查工作;另一方面则从调查指标的变异度、统计方法的局限性、医疗机构的规模大小、实现信息化手段能获取现患率数据等方面认为无需每年开展现患率调查。建议相关部门应根据医疗机构现状,对相关法规进行适当的修订,以达到真正的作用。
The necessity of annual prevalence surveys in medical institutions was discussed through a special debate organized by the Shanghai International Forum for Infection Control and Prevention(SIFIC).The pros and cons of the two parties debated this topic through reviewing the laws and regulations and literatures at home and abroad,through argumentation,free debate,and the basic links of the controversy.One party insisted that the current prevalence rate survey should be carried out every year,and the opinion was based on the requirements of " Hospital Infection Management Measures" in China and the advantages of the current investigation of prevalence rate,such as saving time and effort,obtaining more comprehensive data analysis results,multi-sector collaboration,and reflecting the linkage of infection control work.The counter-party believed that annual survey on prevalence rate is not necessary,which was concluded from the variability of the survey indicators,the limitations of statistical methods,the size of medical institutions,and the possibility of obtaining the data on the prevalence rate by informatization means.It is recommended that relevant departments should make appropriate revisions to relevant regulations according to the status quo of medical institutions to achieve its real role.
The necessity of annual prevalence surveys in medical institutions was discussed through a special debate organized by the Shanghai International Forum for Infection Control and Prevention(SIFIC).The pros and cons of the two parties debated this topic through reviewing the laws and regulations and literatures at home and abroad,through argumentation,free debate,and the basic links of the controversy.One party insisted that the current prevalence rate survey should be carried out every year,and the opinion was based on the requirements of " Hospital Infection Management Measures" in China and the advantages of the current investigation of prevalence rate,such as saving time and effort,obtaining more comprehensive data analysis results,multi-sector collaboration,and reflecting the linkage of infection control work.The counter-party believed that annual survey on prevalence rate is not necessary,which was concluded from the variability of the survey indicators,the limitations of statistical methods,the size of medical institutions,and the possibility of obtaining the data on the prevalence rate by informatization means.It is recommended that relevant departments should make appropriate revisions to relevant regulations according to the status quo of medical institutions to achieve its real role.
引文
[1]中华人民共和国卫生部.医院感染监测规范(WS/T312-2009)[S].中华人民共和国卫生部,2009.
[2]孙迎娟,唐一琳,徐桂强,等,住院患者医院感染患病率调查分析[J].中华医院感染学杂志,2017,27(17):3925-3928.
[3]杨金燕,索继江,许玉冰,等.综合医院两年医院感染情况分析[J].中华医院感染学杂志,2016,26(8):1898-1900.
[4]尹丹萍,何多多,巩霞.某三甲医院2014-2016年医院感染现患率调查[J].中华医院学杂志,2017,27(6):1405-1408.
[5]朱熠,张淑敏,潘颖颖,等.新疆生产建设兵团18家医院横断面调查分析[J].中华医院感染学杂志,2017,27(7):1638-1640.
[6]余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(8):1175-1178.
[7]江敏,袁可欣,孙薇,等.2016年大庆市医院感染现患率调查分析[J].中华医院感染学杂志,2018,28(6):946-948.
[8]王思淼,李佳佳,金鑫,等.2014年某三甲甲等军队医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(16):3819-3821.
[9]张莉霞,张红义,蔡亚丽,等.某院三年医院感染横断面调查[J].中华医院感染学杂志,2018,28(14):2134-2136,2140.
[10]李璐,索继江,高岩,等.2014-2017年某三级甲等综合医院医院感染现患率的变化趋势分析[J].中华医院感染学杂志,2018,28(8):1170-1174.
[11]Finn J.Applicatiln of SBDD to the discovery of antibacterial drugs[J].Methods Mol Biol.2012,841:291-319.
[12]翁晓芳,袁艳玲,周爱军,等.一级医疗机构医院感染现患率调查误差分析与改进对策[J].中华医院感染学杂志,2018,28(11):1728-1731.
[13]牟霞,徐艳,张骥,等.依托信息化进行医院感染现患率调查[J].中华医院感染学杂志,2014,24(19):4887-4889.
[14]罗西贝,李正兰,徐艳春,等.运用医院感染实时监控系统进行医院感染现患率的调查与分析[J].疾病监测,2017,32(8):660-663.
[15]赵晋,同俏静,袁玉华,等.医院感染现患率调查分析[J].中华医院感染学杂志,2015,25(8):1770-1772.
[16]张丽伟,冯诚怿,江淑芳,等.2015年某院住院患者医院感染现患率调查及影响因素分析[J].中华医院感染学杂志,2016,26(22):5107-5109.
[17]李海峰,郑东春,于力娜,等.两种方法调查医院感染现患率结果比较与分析[J].中华医院感染学杂志,2015,25(21):4897-4899.
[18]沈瑞红,傅小芳,顾崎,等.2011-2015年某综合医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(18):4195-4197.
[19]劳一群,曾娟,柳剑,等.2010-2014年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(2):443-447.
[20]梁玉春,泽仁拉姆,唐冠男,等.县级医院医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(22):5235-5236,5280.
[21]程兴东,陈雪梅,李同欢,等.住院患儿医院感染现患率与相关因素分析[J].中华医院感染学杂志,2018,28(12):1888-1891.
[22]商丽妍,吴菲,李海峰,等.沈阳市四所综合性医院3年医院感染现患率调查[J].中华医院感染学杂志,2018,28(13):2049-2052.
[23]陶敏,杨秀敏,邢小明.住院患者医院感染现患率调查[J].中华医院感染学杂志,2015,25(2):363-365.
[24]宫雅琪,谭莉,刘小丽,等.武汉地区2010-2014年医院感染横断面调查研究[J].中华医院感染学杂志,2018,28(13):2044-2048.
[25]杨慧宁,冀超,张娜,等.老年患者医院感染现状分析[J].中华医院感染学杂志,2016,26(22):5110-5112.
[26]纪文秀,王静.老年患者医院感染影响因素及临床分析[J].中华医院感染学杂志,2013,23(21):5171-5172.
[27]李颖,许文,戈伟,等.三级医院老年患者医院感染现状及影响因素分析[J].中华医院感染学杂志,2018,28(8):1179-1182.
[28]程文琴,冯鑫,李婧,等.医院感染横断面调查分析[J].中华医院感染学杂志,2017,27(1):212-214,240.
[29]Mitt P,Metsvaht T,Adamson V,et al.Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit[J].J Hosp Infect,2014,86(2):95-99.
[30]Walaszek M.The analysis of the occurrence of nosocomial infections in the neurosurgical ward in the District Hospital from 2003-2012[J].Przegl Epidemiol,2015,69(3):507-514.
[31]Sun B.Nosocomial infection in China:management status and solutions[J].Am J Infect Control,2016,44(7):851-852.
[32]Richtmann R,Siliprandi EM,Rosenthal VD,et al.Surgical site infection rates in four cities in Brazil:findings of the international nosocomial infection control consortium[J].Surg Infect(Larchmt),2016,17(1):53-57.
[33]Ling ML,Apisarnthanarak A,Madriaga G.The burden of healthcare-associated infections in southeast Asia:a systematic literature review and meta analysis[J].Clin Infect Dis,2015,60(11):1690-1699.
[34]Garc ia H,Torres-Gutierrez J,Peregrino-Bejarano L,et al.Risk factors for nosocomial infection in a levelⅢNeonatal Intensive Care Unit[J].Gac Med Mex,2015,151(6):711-719.
[35]蒙巍,金宗英,骆丽平,等.2014-2016年某中医医院现患率调查分析[J].中华医院感染学杂志,2017,27(4):823-826.
[36]Saint S,Greene MT,Krein SL,et al.A program to prevent catheter-associated urinary tract infection in acute care[J].NEngl J Med,2016,374(22):2111-2119.
[37]Mancini A,Verdini D,La Vigna G,et al.Retrospective analysis of nosocomial infections in an Italian tertiary care hospital[J].New Microbiol,2016,39(3):197-205.
[2]孙迎娟,唐一琳,徐桂强,等,住院患者医院感染患病率调查分析[J].中华医院感染学杂志,2017,27(17):3925-3928.
[3]杨金燕,索继江,许玉冰,等.综合医院两年医院感染情况分析[J].中华医院感染学杂志,2016,26(8):1898-1900.
[4]尹丹萍,何多多,巩霞.某三甲医院2014-2016年医院感染现患率调查[J].中华医院学杂志,2017,27(6):1405-1408.
[5]朱熠,张淑敏,潘颖颖,等.新疆生产建设兵团18家医院横断面调查分析[J].中华医院感染学杂志,2017,27(7):1638-1640.
[6]余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(8):1175-1178.
[7]江敏,袁可欣,孙薇,等.2016年大庆市医院感染现患率调查分析[J].中华医院感染学杂志,2018,28(6):946-948.
[8]王思淼,李佳佳,金鑫,等.2014年某三甲甲等军队医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(16):3819-3821.
[9]张莉霞,张红义,蔡亚丽,等.某院三年医院感染横断面调查[J].中华医院感染学杂志,2018,28(14):2134-2136,2140.
[10]李璐,索继江,高岩,等.2014-2017年某三级甲等综合医院医院感染现患率的变化趋势分析[J].中华医院感染学杂志,2018,28(8):1170-1174.
[11]Finn J.Applicatiln of SBDD to the discovery of antibacterial drugs[J].Methods Mol Biol.2012,841:291-319.
[12]翁晓芳,袁艳玲,周爱军,等.一级医疗机构医院感染现患率调查误差分析与改进对策[J].中华医院感染学杂志,2018,28(11):1728-1731.
[13]牟霞,徐艳,张骥,等.依托信息化进行医院感染现患率调查[J].中华医院感染学杂志,2014,24(19):4887-4889.
[14]罗西贝,李正兰,徐艳春,等.运用医院感染实时监控系统进行医院感染现患率的调查与分析[J].疾病监测,2017,32(8):660-663.
[15]赵晋,同俏静,袁玉华,等.医院感染现患率调查分析[J].中华医院感染学杂志,2015,25(8):1770-1772.
[16]张丽伟,冯诚怿,江淑芳,等.2015年某院住院患者医院感染现患率调查及影响因素分析[J].中华医院感染学杂志,2016,26(22):5107-5109.
[17]李海峰,郑东春,于力娜,等.两种方法调查医院感染现患率结果比较与分析[J].中华医院感染学杂志,2015,25(21):4897-4899.
[18]沈瑞红,傅小芳,顾崎,等.2011-2015年某综合医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(18):4195-4197.
[19]劳一群,曾娟,柳剑,等.2010-2014年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(2):443-447.
[20]梁玉春,泽仁拉姆,唐冠男,等.县级医院医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(22):5235-5236,5280.
[21]程兴东,陈雪梅,李同欢,等.住院患儿医院感染现患率与相关因素分析[J].中华医院感染学杂志,2018,28(12):1888-1891.
[22]商丽妍,吴菲,李海峰,等.沈阳市四所综合性医院3年医院感染现患率调查[J].中华医院感染学杂志,2018,28(13):2049-2052.
[23]陶敏,杨秀敏,邢小明.住院患者医院感染现患率调查[J].中华医院感染学杂志,2015,25(2):363-365.
[24]宫雅琪,谭莉,刘小丽,等.武汉地区2010-2014年医院感染横断面调查研究[J].中华医院感染学杂志,2018,28(13):2044-2048.
[25]杨慧宁,冀超,张娜,等.老年患者医院感染现状分析[J].中华医院感染学杂志,2016,26(22):5110-5112.
[26]纪文秀,王静.老年患者医院感染影响因素及临床分析[J].中华医院感染学杂志,2013,23(21):5171-5172.
[27]李颖,许文,戈伟,等.三级医院老年患者医院感染现状及影响因素分析[J].中华医院感染学杂志,2018,28(8):1179-1182.
[28]程文琴,冯鑫,李婧,等.医院感染横断面调查分析[J].中华医院感染学杂志,2017,27(1):212-214,240.
[29]Mitt P,Metsvaht T,Adamson V,et al.Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit[J].J Hosp Infect,2014,86(2):95-99.
[30]Walaszek M.The analysis of the occurrence of nosocomial infections in the neurosurgical ward in the District Hospital from 2003-2012[J].Przegl Epidemiol,2015,69(3):507-514.
[31]Sun B.Nosocomial infection in China:management status and solutions[J].Am J Infect Control,2016,44(7):851-852.
[32]Richtmann R,Siliprandi EM,Rosenthal VD,et al.Surgical site infection rates in four cities in Brazil:findings of the international nosocomial infection control consortium[J].Surg Infect(Larchmt),2016,17(1):53-57.
[33]Ling ML,Apisarnthanarak A,Madriaga G.The burden of healthcare-associated infections in southeast Asia:a systematic literature review and meta analysis[J].Clin Infect Dis,2015,60(11):1690-1699.
[34]Garc ia H,Torres-Gutierrez J,Peregrino-Bejarano L,et al.Risk factors for nosocomial infection in a levelⅢNeonatal Intensive Care Unit[J].Gac Med Mex,2015,151(6):711-719.
[35]蒙巍,金宗英,骆丽平,等.2014-2016年某中医医院现患率调查分析[J].中华医院感染学杂志,2017,27(4):823-826.
[36]Saint S,Greene MT,Krein SL,et al.A program to prevent catheter-associated urinary tract infection in acute care[J].NEngl J Med,2016,374(22):2111-2119.
[37]Mancini A,Verdini D,La Vigna G,et al.Retrospective analysis of nosocomial infections in an Italian tertiary care hospital[J].New Microbiol,2016,39(3):197-205.
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