广东省265所医疗机构住院患者抗菌药物治疗前病原学送检率管理状况与指标调查

A survey on the management status and indicators of pathogen detection rate before antimicrobial treatment of inpatients in 265 medical institutions in Guangdong Province

摘要:

目的 评估广东省二级以上医疗机构住院患者抗菌药物治疗前病原学送检管理和指标状况,为推动区域内病原学送检质量改进提供方向和决策依据。方法 通过网络问卷调查和系统报送方式, 调查广东省21个地市二级以上医疗机构的管理状况,信息系统功能以及病原学送检率指标信息。分别于2023年7月15日—8月8日 对哨点监测医疗机构进行基线调查,11月7—30日启动非哨点监测医疗机构基线调查,2024年1月15—30日完成所有医疗机构指标信息调查。结果 共调查265所医疗机构,三级医疗机构在成立专项工作小组(83.98%)、制定专项行动改进方案(79.01%)、建立病原学送检率管理制度(91.71%)、制定管理考核方案(76.80%)的比率均高于二级医疗机构,差异均有统计学意义(均P＜0.05)。三级医疗机构在具备各项信息系统功能的比例上均高于二级医疗机构(均P＜0.05)。三级医疗机构的住院患者抗菌药物治疗前病原学送检率(61.07%)及医院感染诊断相关病原学送检率(88.00%)均高于二级医疗机构(均P＜0.05)。不同类型医疗机构中,妇幼保健院的住院患者抗菌药物治疗前病原学送检率高于其他类型医疗机构,其他专科医院医院感染诊断相关病原学送检率最高,中医院联合使用重点抗菌药物治疗前病原学送检率最低,差异均有统计学意义(均P＜0.05)。结论 三级医疗机构在管理策略及信息化建设方面比二级医疗机构更具有优势,二级医疗机构需要更多指导与支持。专项行动应加强对不同等级及类型医疗机构病原学送检率指标的监测与分析,更有效提升质量改进水平。

Abstract:

Objective To evaluate the management and indicators of pathogen detection before antimicrobial treatment for inpatients in second level and above medical institutions (MIs) in Guangdong Province, and provide direction and decision-making basis for the improvement of pathogen detection quality in the region. Methods The ma-nagement status, information system functions, and pathogen detection rate indicators of secondary and above MIs in 21 cities in Guangdong Province was surveyed through online questionnaire surveys and system submission. A baseline survey on sentinel monitoring MIs was conducted from July 15th to August 8th, 2023. From November 7th to 30th, a baseline survey on non-sentinel monitoring MIs was launched. Surveys on indicator information of all MIs were completed from January 15th to 30th, 2024. Results A total of 265 MIs were surveyed, and the proportions of establishing special working groups (83.98%), developing special action improvement plans (79.01%), establishing pathogen detection rate management systems (91.71%), and developing management assessment plans (76.80%) of tertiary MIs were all higher than that of secondary MIs, differences were all statistically significant (all P<0.05). The proportion of tertiary MIs with various information system functions was higher than that of secondary MIs (all P<0.05). The pathogen detection rate (61.07%) before antimicrobial treatment and healthcare-associated infection (HAI) diagnosis-related pathogen detection rate (88.00%) of inpatients in tertiary MIs were both higher than those in secondary MIs (both P<0.05). Among different types of MIs, pathogen detection rate before antimicrobial treatment of inpatients in maternal and child health MIs was higher than that in other types of MIs. HAI diagnosis-related pathogen detection rate in other specialized hospitals was the highest, and pathogen detection rate before combined use of key antimicrobial treatment in traditional Chinese medicine hospitals was the lowest, differences were all statistically significant (all P<0.05). Conclusion Tertiary MIs have more advantages in management strategies and information technology construction than secondary MIs, secondary MIs need more guidance and support. Monitoring and analysis of pathogen detection rate indicators in MIs of different levels and types should be strengthened through special actions.