精细化管理在减少多重耐药菌院内感染中的应用效果
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摘要
目的探讨精细化管理在减少多重耐药菌院内感染中的应用效果。方法选择我院2016年1月至2017年12月检测出的238例多重耐药菌院内感染病例为观察对象,其中2016年1～12月医院采取常规管理模式,2017年1～12月医院采取精细化管理模式。比较实施精细化管理前、后多重耐药菌院内感染率,并分析患者多重耐药菌院内感染发生部位、菌种分布及感染科室分布等。结果实施精细化管理后多重耐药菌院内感染发生率明显低于实施前(P<0.05)。实施精细化管理前、后多重耐药菌院内感染主要来源于痰液,其次是尿液、伤口渗出物;多重耐药菌院内感染排名前三的病原菌分别为产ESBL大肠埃希菌、耐碳青霉烯类鲍曼不动杆菌和产ESBL肺炎克雷伯菌;多重耐药菌院内感染科室排名前三的分别为中心ICU、神经外科及呼吸内科。结论精细化管理能够促使多重耐药菌管理更加规范有效,可提高医务人员对多重耐药菌的防控意识及技能,使多重耐药菌院内感染率明显下降。
Objective To explore the application effect of fine management in reducing nosocomial infection of multidrug-resistant bacteria. Methods A total of 238 cases of nosocomial infection of multidrug-resistant bacteria detected in our hospital from January 2016 to December 2017 were selected as observation objects. Among them, from January to December 2016, hospital adopted the conventional management mode, and from January to December 2017, hospital adopted the fine management mode. The nosocomial infection rates of multidrug-resistant bacteria before and after the implementation of fine management were compared and the site of nosocomial infection of patients with multidrug-resistant bacteria, bacterial species distribution and infection department distribution were analyzed. Results The incidence of nosocomial infection of multidrug-resistant bacteria after the implementation of fine management was significantly lower than before implementation(P <0.05). Before and after the implementation of fine management, nosocomial infection of multidrug-resistant bacteria mainly came from sputum, followed by urine and wound exudates; the top three pathogens of nosocomial infection of multidrug-resistant bacteria were ESBL-producing Escherichia coli, carbapenem-resistant Acinetobacter baumannii and ESBL-producing Klebsiella pneumoniae; the top three in nosocomial infection departments of multidrug-resistant bacteria center ICU, neurosurgery department and respiratory medicine department. Conclusion Fine management can make the management of multidrug-resistant bacteria more standardized and effective, which can improve the awareness and skills of medical staff in the prevention and control of multidrug-resistant bacteria, and significantly reduce the nosocomial infection rate of multidrug-resistant bacteria.
Objective To explore the application effect of fine management in reducing nosocomial infection of multidrug-resistant bacteria. Methods A total of 238 cases of nosocomial infection of multidrug-resistant bacteria detected in our hospital from January 2016 to December 2017 were selected as observation objects. Among them, from January to December 2016, hospital adopted the conventional management mode, and from January to December 2017, hospital adopted the fine management mode. The nosocomial infection rates of multidrug-resistant bacteria before and after the implementation of fine management were compared and the site of nosocomial infection of patients with multidrug-resistant bacteria, bacterial species distribution and infection department distribution were analyzed. Results The incidence of nosocomial infection of multidrug-resistant bacteria after the implementation of fine management was significantly lower than before implementation(P <0.05). Before and after the implementation of fine management, nosocomial infection of multidrug-resistant bacteria mainly came from sputum, followed by urine and wound exudates; the top three pathogens of nosocomial infection of multidrug-resistant bacteria were ESBL-producing Escherichia coli, carbapenem-resistant Acinetobacter baumannii and ESBL-producing Klebsiella pneumoniae; the top three in nosocomial infection departments of multidrug-resistant bacteria center ICU, neurosurgery department and respiratory medicine department. Conclusion Fine management can make the management of multidrug-resistant bacteria more standardized and effective, which can improve the awareness and skills of medical staff in the prevention and control of multidrug-resistant bacteria, and significantly reduce the nosocomial infection rate of multidrug-resistant bacteria.
引文
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[3]卢志军.院内痰培养多重耐药菌感染病原学及耐药分析[J].中国实用医药,2013,8(10):174-175.
[4]胡必杰,宗志勇,顾克菊.多重耐药菌感染控制最佳实践[M].上海:上海科学技术出版社,2012:108.
[5]郭广芹,董玉敏,高文杰,等.多部门协作控制多重耐药菌医院感染的研究[J].转化医学杂志,2015,4(3):151-153,160.
[6]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[7]李国宏.个案追踪法在医院护理评审中的应用[J].中国护理管理2014,14(2):124-126.