口腔门诊感染控制风险评估的建立与实施

Establishment and implementation of risk assessment for infection control in oral outpatient department

摘要:

目的 建立口腔门诊感染控制风险评估体系, 掌握口腔门诊感染高风险因素, 为口腔诊疗感染控制措施的持续改进提供方向。 方法 基于德尔菲专家咨询法, 抓取国家行业标准、规范中与口腔门诊感染控制相关条款, 建立风险评估体系, 评估某三级口腔专科医院门诊医院感染风险, 运用失效模式与效应分析法定量获得高风险点。 结果 建立了口腔门诊感染控制风险评估体系, 包括一级指标3个, 二级指标15个, 三级指标74个。共查找风险点18个, 包括医务人员对手卫生时机掌握不正确, 保洁用具清洗消毒方法不正确, 手卫生依从率低于全院基线水平, 盛装使用后织物的容器和区域未及时消毒, 保洁用具分区使用不明确, 感染控制制度内容不齐全或不正确, 紫外线灯辐照强度未定期监测, 医疗废物盛装过满, 无清洁消毒质量考核和防护用品未正确穿戴或脱卸等。 结论 初步形成口腔门诊感染控制风险指标体系建立方法, 并找出口腔门诊感染控制措施执行中可能存在的高风险点, 可为口腔门诊感染控制工作的持续改进提供参考。

Abstract:

Objective To establish a risk assessment system for infection control in oral outpatient department, grasp the high risk factors, and provide direction for the continuous improvement of infection control measures in oral diagnosis and treatment. Methods Based on the Delphi expert consultation method, clauses in national industry standards and specifications related to infection control in oral outpatient department were captured, and a risk assessment system was established, healthcare-associated infection risks of outpatient department of a tertiary stomatological specialty hospital were evaluated, high-risk points were quantitatively obtained with the failure mode and effect analysis method. Results The risk assessment system for infection control in oral outpatient department was established, including 3 first-level indexes, 15 second-level indexes and 74 third-level indexes.A total of 18 risk points were identified, including incorrect hand hygiene opportunities of health care workers, incorrect cleaning and disinfection methods for cleaning appliances, lower hand hygiene compliance rate than the hospital-wide baseline, non-timely disinfection for containers and areas of fabrics after use, unclear use location of cleaning appliances, incomplete or incorrect infection control system, irregular monitoring of ultraviolet lamp irradiation intensity, overloading of medical waste, without quality assessment on cleaning and disinfection, as well as incorrect wearing or removal of protective equipment. Conclusion The method for risk index system for infection control in the oral outpatient department is initially established, and the possible high-risk points in the implementation of infection control measures in the oral outpatient department are identified, which provide reference for the continuous improvement of infection control in the oral outpatient department.