医院感染病例漏报的前瞻性监测与控制
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摘要
目的探索医院感染病例前瞻性监测与漏报控制方法,分析其实施效果,为有针对性地制定医院感染病例漏报监控策略提供依据。方法 2016年1月—2017年6月运用品管圈(QCC)方法,前瞻性监测住院患者中的医院感染病例,对医院感染漏报进行控制。结果建成"信息化系统智能筛查+移动通讯短信提醒+院感督导"三位一体的前瞻式医院感染病例堵漏监控模式,第一轮PDCA循环后医院感染漏报率由QCC活动前的79.16%降至59.75%,差异有统计学意义(χ~2=208.821,P=0.000);与第一轮PDCA循环后的医院感染漏报率相比,第二轮PDCA循环后医院感染漏报率降至26.18%,差异有统计学意义(χ~2=200.075,P=0.002)。结论在医院感染病例漏报发生前,采取积极前瞻性的防控,可有效避免医院感染病例漏报。
Objective To explore the prospective monitoring and control methods for missing reporting of healthcare-associated infection(HAI)cases,analyze its implementation efficacy,provide basis for formulating targeted strategy for monitoring missing report of HAI.Methods From January 2016 to June 2017,the quality control circle(QCC)method was used to prospectively monitor HAI cases in hospitalized patients,missing reporting of HAI was controlled.Results "Information system intelligence screening+mobile messaging alerts+ HAI supervision"trinity monitoring model for avoid missing reporting of HAI cases was established,after the first round of PDCA(plan,do,check,action)cycle,missing reporting rate of HAI decreased from 79.16% before QCC to 59.75% after QCC,difference was statistically significant(χ~2=208.821,P=0.000).Compared with missing reporting rate of HAI after the first round of PDCA,missing reporting rate of HAI after the second round of PDCA dropped to 26.18%,difference was statistically significant(χ~2=200.075,P=0.002).Conclusion Active prospective prevention and control before missing reporting of HAI can effectively avoid missing reporting of HAI cases.
Objective To explore the prospective monitoring and control methods for missing reporting of healthcare-associated infection(HAI)cases,analyze its implementation efficacy,provide basis for formulating targeted strategy for monitoring missing report of HAI.Methods From January 2016 to June 2017,the quality control circle(QCC)method was used to prospectively monitor HAI cases in hospitalized patients,missing reporting of HAI was controlled.Results "Information system intelligence screening+mobile messaging alerts+ HAI supervision"trinity monitoring model for avoid missing reporting of HAI cases was established,after the first round of PDCA(plan,do,check,action)cycle,missing reporting rate of HAI decreased from 79.16% before QCC to 59.75% after QCC,difference was statistically significant(χ~2=208.821,P=0.000).Compared with missing reporting rate of HAI after the first round of PDCA,missing reporting rate of HAI after the second round of PDCA dropped to 26.18%,difference was statistically significant(χ~2=200.075,P=0.002).Conclusion Active prospective prevention and control before missing reporting of HAI can effectively avoid missing reporting of HAI cases.
引文
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[10]武迎宏,曹煜隆,蔡虻,等.基于住院患者病案首页高风险病例来抽查医院感染漏报的方法探讨[J].中华医院感染学杂志,2017,27(12):2827-2829.
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[12]魏雪芳,邵宜波,张磊,等.降低医院感染漏报率的措施及其效果评价[J].中华医院感染学杂志,2009,19(3):304-305.
[13]麦尔哈巴·麦麦提,丁清,李文玉,等.某三甲医院感染漏报原因分析及改进措施探讨[J].中国消毒学杂志,2016,33(5):457-459.
[14]曹卫平,吕为农,郑君,等.医院感染漏报的监测及其评价研究[J].中华医院感染学杂志,2014,24(19):4893-4894,4897.
[2] Garcíalvarez L,Aylin P,Tian J,et al.Data linkage between existing healthcare databases to support hospital epidemiology[J].J Hosp Infect,2011,79(3):231-235.
[3]梅卫玲,周宏宇,杨永丰.建立医院感染管理信息系统降低医院感染漏报率[J].中华医院感染学杂志,2010,20(2):3366-3367,3383.
[4]张幸国.医院品管圈活动实战与技巧[M].杭州:浙江大学出版社,2010.
[5] Rhame FS,SudderthWD.Incidence and prevalence as used in the analysis of the occurrence of nosocomial infections[J].Am J Epidemiol,1981,113(1):1-11.
[6]中华人民共和国卫生部.关于印发医院感染诊断标准(试行)的通知[EB/OL].(2001-11-07)[2014-01-01].http://www.moh.gov.cn/mohyzs/s3593/200804/18625.shtml.
[7]徐秀华.临床医院感染学[M].长沙:湖南科学技术出版社,2005:66.
[8] Thiolet JM,Bernet C,Carbonne A.External reporting of nosocomial infections,France[J].Bulletin Epidemiol Hebd,2008,31(32):265-268.
[9]张京利,王力红,赵霞,等.医院感染漏报率抽样调查方法探索[J].中华医院感染学杂志,2011,21(20):4304-4305.
[10]武迎宏,曹煜隆,蔡虻,等.基于住院患者病案首页高风险病例来抽查医院感染漏报的方法探讨[J].中华医院感染学杂志,2017,27(12):2827-2829.
[11]牛莉.医院感染病例漏报分析[J].基层医学论坛,2014,18(s1):125.
[12]魏雪芳,邵宜波,张磊,等.降低医院感染漏报率的措施及其效果评价[J].中华医院感染学杂志,2009,19(3):304-305.
[13]麦尔哈巴·麦麦提,丁清,李文玉,等.某三甲医院感染漏报原因分析及改进措施探讨[J].中国消毒学杂志,2016,33(5):457-459.
[14]曹卫平,吕为农,郑君,等.医院感染漏报的监测及其评价研究[J].中华医院感染学杂志,2014,24(19):4893-4894,4897.