追踪方法学在血液透析用水微生物污染事件调查中的应用

Applicacation of tracer methodology in investigation of microbial contamination of hemodialysis fluid

摘要:

目的 探讨追踪方法学在血液透析用水微生物污染事件调查中的应用效果。 方法 运用追踪方法学对血液透析用水微生物监测不合格的事件进行现场追踪，收集相关资料，应用质量管理工具进行分析，找出存在的根源问题，并从中进行专项改善，完善血液透析室消毒隔离制度，促进医院感染管理质量持续改进，保障血液透析安全。 结果 实施系统追踪前采集血液透析液及相关标本125份，合格80份，合格率为64.0%。进行全面消毒整改后，又对透析用水连续监测采样持续半年，采样125份，合格116份，合格率为92.8%。改善前后血液透析液及相关标本检测结果合格率比较，差异有统计学意义（P<0.05）。 结论 追踪方法学是一种非常有效的质量管理工具，可用于透析用水微生物污染的不良事件调查及质量持续改进，可在医院感染管理实际工作中推广、应用。

Abstract:

Objective To explore the application effect of tracer methodology in the investigation of microbial contamination of hemodialysis fluid. Methods Tracer methodology was used to perform on-site tracing for the unqualified events in microbial monitoring on hemodialysis fluid, relevant data were collected and analyzed with quality management tool, the existing root causes were found out, special rectification was made, disinfection and isolation system in hemodialysis room was improved, so as to promote continuous improvement of management quality of healthcare-associated infection and ensure safety of hemodialysis. Results Before the implementation of tracer system, 125 hemodialysis fluid and relevant specimens were taken, 80 of which were qualified, qualified rate was 64.0%. After comprehensive rectification on disinfection, dialysis fluid was continuously monitored and sampled for half a year, 125 specimens were taken, 116 were qualified, qualified rate was 92.8%. There was significant diffe-rence in the qualified rate of hemodialysis fluid and related specimens before and after improvement (P<0.05). Conclusion Tracer methodology is a very effective quality management tool, which can be used for investigation on adverse events of dialysis fluid microbial contamination and continuous quality improvement, and can be promoted and applied in the actual practice of healthcare-associated infection management.