实施院感专职小组模式改善妇产科患者手术部位感染的效果观察
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摘要
目的探究妇产科患者开展院感专职小组模式对手术部位感染情况。方法 2017年1—12月期间妇产科未开展院感专职小组模式收入手术患者共计360例作为该次对照组,另选取2018年1—12月期间妇产科开展院感专职小组模式收入手术患者共计360例作为该次观察组,对两组感染、控制情况进行比较。结果观察组手术部位感染发生率占比为3.33%,低于对照组10.83%,两组差异有统计学意义(P<0.05),对照组中革兰阴性菌检出株数为43株,占比63.24%,革兰阳性菌检出株数13株,占比19.12%,真菌检出株数12例,占比17.65%,观察组中革兰阴性菌检出株数为24株,占比66.67%,革兰阳性菌检出株数8株,占比22.22%,真菌检出株数4例,占比11.11%,观察组医务人员管理、工作环境管理、医疗器械、用品管理、消毒隔离总质量评分高于对照组,两组差异有统计学意义(P<0.05),观察组医院感染知识知晓、手卫生知识知晓、抗菌药物合格使用、无菌操作评分高于对照组,两组差异有统计学意义(P<0.05)。结论院内妇产科通过开展院感专职小组模式,能进一步降低手术部位感染发生率,能提高医护人员对感染发生知识,对院内整体感染率控制起着重要作用。
Objective To investigate the infection status of surgical sites in patients with obstetrics and gynecology. Methods A retrospective analysis of 360 patients who had not undergone a full-time internship group in the Department of Obstetrics and Gynecology from January to December 2017 was used as the control group, and women from January to December2018 were selected. The department carried out a total of 360 patients with a full-time group mode of operation, and used this observation group, to compare the infection and control of the two groups. Results The incidence of surgical site infection in the observation group was 3.33%, which was lower than that in the control group(10.83%). The difference between the two groups was significant(P<0.05). In the control group, the number of Gram-negative bacteria was 43, accounting for63.24%. Gram-positive bacteria detected 13 strains, accounting for 19.12%, and fungi detected 12 strains, accounting for17.65%. In the observation group, the number of Gram-negative bacteria detected was 24, accounting for 66.67%, Gram-positive of 8 strains were detected, accounting for 22.22%, and 4 cases were detected by fungi, accounting for 11.11%. The total quality of medical staff management, work environment management, medical equipment, supplies management, disinfection and isolation in the observation group was higher than that of the control group. The difference between the two groups was significant(P<0.05). The observation group had no knowledge of hospital infection, knowledge of hand hygiene, qualified use of antibiotics, and the score of aseptic operation was higher than that of the control group. The difference between the two groups was significant(P<0.05). Conclusion In-hospital obstetrics and gynecology can further reduce the incidence of infection at the surgical site by carrying out the hospital-wide full-time team model, which can improve the knowledge of infection among medical staff and play an important role in controlling the overall infection rate in the hospital.
Objective To investigate the infection status of surgical sites in patients with obstetrics and gynecology. Methods A retrospective analysis of 360 patients who had not undergone a full-time internship group in the Department of Obstetrics and Gynecology from January to December 2017 was used as the control group, and women from January to December2018 were selected. The department carried out a total of 360 patients with a full-time group mode of operation, and used this observation group, to compare the infection and control of the two groups. Results The incidence of surgical site infection in the observation group was 3.33%, which was lower than that in the control group(10.83%). The difference between the two groups was significant(P<0.05). In the control group, the number of Gram-negative bacteria was 43, accounting for63.24%. Gram-positive bacteria detected 13 strains, accounting for 19.12%, and fungi detected 12 strains, accounting for17.65%. In the observation group, the number of Gram-negative bacteria detected was 24, accounting for 66.67%, Gram-positive of 8 strains were detected, accounting for 22.22%, and 4 cases were detected by fungi, accounting for 11.11%. The total quality of medical staff management, work environment management, medical equipment, supplies management, disinfection and isolation in the observation group was higher than that of the control group. The difference between the two groups was significant(P<0.05). The observation group had no knowledge of hospital infection, knowledge of hand hygiene, qualified use of antibiotics, and the score of aseptic operation was higher than that of the control group. The difference between the two groups was significant(P<0.05). Conclusion In-hospital obstetrics and gynecology can further reduce the incidence of infection at the surgical site by carrying out the hospital-wide full-time team model, which can improve the knowledge of infection among medical staff and play an important role in controlling the overall infection rate in the hospital.
引文
[1]陆春红,陈珠,马云霄,等.感控专职小组对妇产科患者手术部位感染的影响[J].中华医院感染学杂志,2017,27(19):4545-4548.
[2]蚁少华,王美容,陈碧贞,等.福建省42所中医院医院感染管理现状调查[J].中国感染控制杂志,2018,17(4):320-324.
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[7]李萍.盆腔脓肿并发感染性休克的临床体会[J].实用妇科内分泌电子杂志,2018,5(32):36-37.
[8]谭小欣,曹向军,曹飞,等.胸腰椎骨折患者手术部位感染的危险因素[J].中国感染控制杂志,2017,16(3):218-220.
[9]何文英,史发林,张玉,等.我国手术部位感染管理现状调查[J].中华医院感染学杂志,2018,28(5):768-771,786.
[10]谢培彦,李元晖,唐玉梅,等.择期脑肿瘤切除术患者手术部位感染危险因素[J].中国感染控制杂志,2017,16(7):650-653.
[11]Viet Hung N,Anh Thu T,Rosenthal VD.Surgical Site Infection Rates in Seven Cities in Vietnam:Findings of the International Nosocomial Infection Control Consortium[J].Surg Infect(Larchmt),2016,17(2):243-249.
[12]胡庆翔,戚文潇,汤瑾,等.骨科创伤后伤口感染和手术部位感染季节趋势的回顾性研究[J].上海交通大学学报:医学版,2018,38(1):63-66.
[13]彭美玲,刘惕,冯诚怿,等.某三级甲等综合医院胸心外科患者手术部位感染调查[J].中国感染控制杂志,2018,17(3):215-218.
[14]芦永华,黄新玲,何文英,等.四肢骨折手术部位感染危险因素多中心调查[J].中国感染控制杂志,2016,15(6):393-396.
[15]刘欣,何文英,黄新玲,等.腹部外科手术部位感染风险预测模型[J].中华医院感染学杂志,2017,27(1):132-135.
[16]李玉森,王吉霞,郭金凤,等.根本原因分析法调查乳甲外科清洁切口手术部位感染事件[J].中国感染控制杂志,2018,17(1):67-69,73.
[17]Choi H J,Adiyani L,Sung J,et al.Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System[J].J Hosp Infect,2016,93(4):339-346.
[18]胡潇云,秦桂英,邱隆敏,等.结直肠手术手术部位感染危险因素的logistic回归分析[J].中国感染控制杂志,2017,16(12):1147-1151.
[19]张晶,张德宇,王丹波.宫颈上皮内瘤变LEEP术后人乳头瘤病毒感染的临床分析[J].国际妇产科学杂志,2018,45(6):658-661.
[2]蚁少华,王美容,陈碧贞,等.福建省42所中医院医院感染管理现状调查[J].中国感染控制杂志,2018,17(4):320-324.
[3]李巧巧,李静,马厚芝,等.我国二级以上医疗机构剖宫产术后手术部位感染发病率的Meta分析[J].中国感染控制杂志,2017,16(12):1130-1136.
[4]石磊,李海峰,阮狄克,等.脊柱术后手术部位感染的危险因素分析[J].中国脊柱脊髓杂志,2017,27(10):908-912.
[5]Duarte-Raya F,Baeza-Zarco FJ.Incidence and risk factors associated with nosocomial infection in pediatric heart surgery[J].Rev Med Inst Mex Seguro Soc,2016,5(2):182-189.
[6]陈颢,王海鹏.不同季节手术患者手术部位感染发病率及其病原菌[J].中国感染控制杂志,2017,16(9):873-875.
[7]李萍.盆腔脓肿并发感染性休克的临床体会[J].实用妇科内分泌电子杂志,2018,5(32):36-37.
[8]谭小欣,曹向军,曹飞,等.胸腰椎骨折患者手术部位感染的危险因素[J].中国感染控制杂志,2017,16(3):218-220.
[9]何文英,史发林,张玉,等.我国手术部位感染管理现状调查[J].中华医院感染学杂志,2018,28(5):768-771,786.
[10]谢培彦,李元晖,唐玉梅,等.择期脑肿瘤切除术患者手术部位感染危险因素[J].中国感染控制杂志,2017,16(7):650-653.
[11]Viet Hung N,Anh Thu T,Rosenthal VD.Surgical Site Infection Rates in Seven Cities in Vietnam:Findings of the International Nosocomial Infection Control Consortium[J].Surg Infect(Larchmt),2016,17(2):243-249.
[12]胡庆翔,戚文潇,汤瑾,等.骨科创伤后伤口感染和手术部位感染季节趋势的回顾性研究[J].上海交通大学学报:医学版,2018,38(1):63-66.
[13]彭美玲,刘惕,冯诚怿,等.某三级甲等综合医院胸心外科患者手术部位感染调查[J].中国感染控制杂志,2018,17(3):215-218.
[14]芦永华,黄新玲,何文英,等.四肢骨折手术部位感染危险因素多中心调查[J].中国感染控制杂志,2016,15(6):393-396.
[15]刘欣,何文英,黄新玲,等.腹部外科手术部位感染风险预测模型[J].中华医院感染学杂志,2017,27(1):132-135.
[16]李玉森,王吉霞,郭金凤,等.根本原因分析法调查乳甲外科清洁切口手术部位感染事件[J].中国感染控制杂志,2018,17(1):67-69,73.
[17]Choi H J,Adiyani L,Sung J,et al.Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System[J].J Hosp Infect,2016,93(4):339-346.
[18]胡潇云,秦桂英,邱隆敏,等.结直肠手术手术部位感染危险因素的logistic回归分析[J].中国感染控制杂志,2017,16(12):1147-1151.
[19]张晶,张德宇,王丹波.宫颈上皮内瘤变LEEP术后人乳头瘤病毒感染的临床分析[J].国际妇产科学杂志,2018,45(6):658-661.