三级管理体系对住院儿童术后感染的预防
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摘要
目的研究三级管理体系对住院手术儿童感染的预防效果。方法选取2013年1月至2014年12月于本院进行手术的2 000例住院儿童为研究对象,其中2013年1~12月收治的1 000例儿童为对照组,2014年1~12月收治的1 000例儿童为观察组。对照组患儿采用常规管理体系,观察组则采用三级管理体系,比较两组医护人员感染知识知晓度、预防态度合格率以及两组住院手术儿童院内感染率,并对感染多重耐药菌进行分析。结果观察组医护人员感染知识知晓度为84.55%,预防态度合格率为90.00%,均显著高于对照组,差异具有统计学意义(χ~2=8.561、11.269,P=0.019、0.008);观察组患儿院内感染率为5.40%,显著低于对照组(14.60%)(χ~2=6.148、P=0.026);共分离出124株病原菌,其中68株凝固酶阴性葡萄球菌构成比最高(占54.84%),其次是链球菌和气球菌等。结论三级管理体系可以有效预防住院手术儿童发生院内感染,提高医护人员的感染知识知晓度和预防态度合格率。
Objective To investigate the effects of three-grade management system on preventing the children with infection after ambulatory surgery. Methods Total of 2 000 hospitalized children with surgery from January 2013 to December 2014 in our hospital were selected. Among whom, 1 000 cases collected from January to December 2013 were collected as the control group, given conventional management system; while 1 000 cases collected from January to December 2014 were collected as the observation group, given three-grade management system. The rates of health care workers' infection knowledge, prevention attitudes and hospitalized surgical children's infection rates of two groups were compared, respectively and the multidrug resistant infections were analyzed. Results The rates of health care workers' infection knowledge and prevention attitudes of the observation group were 84.55% and 90.00%, respectively, significantly higher than those of the control group(χ~2 = 8.561, 11.269; P = 0.019, 0.008). The infection rate of patients in observation group was 5.40%, significantly lower than that(14.60%) of the control group(χ~2 = 6.148, P = 0.026). Total of 124 pathogens were isolated, including 68 strains of MRCNS, as the highest ratio of 54.84%, followed by Streptococcus and Balloons. Conclusions Three-grade management system coule be effective in preventing the infection of hospital inpatient after surgery, and improving the rates of health care workers' infection prevention attitudes and knowledge about infection.
Objective To investigate the effects of three-grade management system on preventing the children with infection after ambulatory surgery. Methods Total of 2 000 hospitalized children with surgery from January 2013 to December 2014 in our hospital were selected. Among whom, 1 000 cases collected from January to December 2013 were collected as the control group, given conventional management system; while 1 000 cases collected from January to December 2014 were collected as the observation group, given three-grade management system. The rates of health care workers' infection knowledge, prevention attitudes and hospitalized surgical children's infection rates of two groups were compared, respectively and the multidrug resistant infections were analyzed. Results The rates of health care workers' infection knowledge and prevention attitudes of the observation group were 84.55% and 90.00%, respectively, significantly higher than those of the control group(χ~2 = 8.561, 11.269; P = 0.019, 0.008). The infection rate of patients in observation group was 5.40%, significantly lower than that(14.60%) of the control group(χ~2 = 6.148, P = 0.026). Total of 124 pathogens were isolated, including 68 strains of MRCNS, as the highest ratio of 54.84%, followed by Streptococcus and Balloons. Conclusions Three-grade management system coule be effective in preventing the infection of hospital inpatient after surgery, and improving the rates of health care workers' infection prevention attitudes and knowledge about infection.
引文
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13 傅静芬,顾军养.综合护理干预降低儿科病房院内感染的临床研究[J].护士进修杂志,2014,27(8):694-696.
14 诸伟红,姚洁,沈小玲,等.三级管理体系对EICU患者医院感染的预防效果[J].中华医院感染学杂志,2015,25(12):2868-2869,2872.
15 陈晓勤,吴丽萍,尹俊.高血压社区综合防治三级管理模式的实践效果评价[J].中国全科医学,2012,15(22):2557-2558,2563.
16 张桂玲,李文慧,柴爱军,等.呼吸内科门诊抗菌药物三级管理干预措施的研究[J].河北医药,2012,34(18):2849-2850.
17 刘君,任换娣.三级管理体系在手术室清洁管理中的应用[J].中国医师杂志,2012,18(Z1):151.
18 谢美,岳虹霓,蒋同平,等.三级管理体系防控新生儿多重耐药菌感染传播的临床效果评价[J].中华现代护理学杂志,2014,20(2):191-193.
19 郭卫红,宋宏先,伍亚云.472株临床分离菌株的药敏试验结果分析[J/CD].中华实验和临床感染病杂志:电子版,2015,9(1):46-48.
20 汪海源,洪涛,吴兴茂,等.ICU内获得性感染细菌谱的时间分布分析[J].中国医科大学学报,2015,9(5):434-437.
2 王菊英,周立荣,唐秀英,等.1781例新生儿至学龄期患儿TORCH检测结果分析[J].中国免疫学杂志,2014,30(2):263-265,270.
3 崔静.开颅术后患者肺部感染相关因素的分析与护理[J/CD].中华实验和临床感染病杂志:电子版,2015,9(1):100-102.
4 郭丽侠,杨宇艳,高彩云.早产儿免疫功能变化及其感染危险因素分析[J].山东医药,2015,(23):44-45.
5 李薛颖,张川波,张秋月,等.腹腔镜下小儿腹股沟斜疝修补手术院内感染原因分析[J].陕西医学杂志,2015,44(1):19-20.
6 李洁,赵普学,许自强,等.癫痫手术患儿医院感染因素及疗效评价[J].中华医院感染学杂志,2014,24(13):3352-3353,3356.
7 Marquet K,Liesenborgs A,Bergs J,et al.Incidence and outcome of inappropriate in-hospital empiric antibiotics for severe infection:a systematic review and meta-analysis[J].Critical Care,2015,19(1):795.
8 乔瑞娟,汪鹏,康倩,等.白银地区5岁以下住院儿童RSV感染流行病学分析[J].中华实验和临床病毒学杂志,2015,29(6):510-514.
9 李明,李玉秀.儿童肾病综合征住院期间感染的构成及危险因素分析[J].海南医学,2013,24(8):1212-1214.
10 罗鑫,刘利君,郑动.某院2013年医院感染与社区感染现患率调查分析[J].重庆医学,2015,44(6):827-829.
11 郑多金,林淑瑜,殷超,等.315株铜绿假单胞菌医院感染的临床分布与耐药性分析[J/CD].中华实验和临床感染病杂志(电子版),2015,(01):61-64.
12 曾淑娟,赵文利,丘惠娴,等.某三级医院新生儿科建设过程中院内感染的特点及原因[J].广东医学,2015,36(17):2728-2730.
13 傅静芬,顾军养.综合护理干预降低儿科病房院内感染的临床研究[J].护士进修杂志,2014,27(8):694-696.
14 诸伟红,姚洁,沈小玲,等.三级管理体系对EICU患者医院感染的预防效果[J].中华医院感染学杂志,2015,25(12):2868-2869,2872.
15 陈晓勤,吴丽萍,尹俊.高血压社区综合防治三级管理模式的实践效果评价[J].中国全科医学,2012,15(22):2557-2558,2563.
16 张桂玲,李文慧,柴爱军,等.呼吸内科门诊抗菌药物三级管理干预措施的研究[J].河北医药,2012,34(18):2849-2850.
17 刘君,任换娣.三级管理体系在手术室清洁管理中的应用[J].中国医师杂志,2012,18(Z1):151.
18 谢美,岳虹霓,蒋同平,等.三级管理体系防控新生儿多重耐药菌感染传播的临床效果评价[J].中华现代护理学杂志,2014,20(2):191-193.
19 郭卫红,宋宏先,伍亚云.472株临床分离菌株的药敏试验结果分析[J/CD].中华实验和临床感染病杂志:电子版,2015,9(1):46-48.
20 汪海源,洪涛,吴兴茂,等.ICU内获得性感染细菌谱的时间分布分析[J].中国医科大学学报,2015,9(5):434-437.