江苏省62所基层医疗机构医院感染管理现状研究

Current status of healthcare-associated infection management in 62 primary medical institutions in Jiangsu Province

摘要:

目的 了解江苏省基层医疗机构医院感染质量控制指标的应用及医院感染管理现状,为基层医疗机构提高医院感染管理工作质量及卫生行政部门制定医院感染管理相关决策提供参考和依据。方法 分析江苏省基层医疗专业质量控制中心收集的该省62所首批基层哨点医疗机构医院感染质量控制指标数据,并对其中20所机构现场检查和考核的结果进行汇总、分析。结果 2023年7月—2024年5月共监测住院患者145 814例, 发现医院感染患者219例、220例次,医院感染发病率、例次发病率均为0.15%,医院感染部位主要为上呼吸道 (40.45%)。手卫生依从率为81.34%(14.29%~100%),正确率为87.90%(18.46%~100%);环境物体表面污染物清除率为77.24%(20.00%~100%),器械、器具和物品清洗合格率为98.76%(10.00%~100%)。现场检查多数基层医疗机构质量控制指标监测数据记录与每月上报至江苏省基层医疗专业质量控制中心数据不相符; 多数基层医疗机构的医务人员感染预防与控制观念不强,知识不足;多数基层医疗机构重点科室存在较多医院感染方面的安全隐患。结论 经过近一年的持续医院感染监测,各基层哨点医疗机构已建立了各自的医院感染发病率数据。部分基层医疗机构的手卫生依从率、正确率以及环境物体表面污染物清除率仍然较低,有较大的提升空间。部分基层医疗机构医院感染预防与控制水平与制度标准之间仍存在明显差距。

Abstract:

Objective To understand the application of healthcare-associated infection (HAI) quality control indicators and current status of HAI management in primary medical institutions in Jiangsu Province, and provide refe-rence and basis for primary medical institutions to improve HAI management quality and for health administrative departments to formulate HAI management relevant policies. Methods Data on HAI quality control indicators co-llected by Jiangsu Provincial Primary Healthcare Professional Quality Control Center from the first batch of 62 primary sentinel medical institutions in the province were analyzed. Results of on-site inspections and assessments of 20 institutions were summarized and analyzed. Results From July 2023 to May 2024, a total of 145 814 inpatients were monitored, 219 patients had 220 episodes of HAI. The incidence and case incidence of HAI were both 0.15%, and the main HAI site was upper respiratory tract (40.45%). The compliance rate and correct rate of hand hygiene were 81.34% (14.29%-100%) and 87.90% (18.46%-100%), respectively. The removal rate of surface pollutant from environmental objects was 77.24% (20.00%-100%), and the qualified rate of cleaning of device, appliances, and articles was 98.76% (10.00%-100%). The monitoring data records of quality control indicators in most primary healthcare institutions during on-site inspections didn’t match the monthly data reported to the Jiangsu Provincial Primary Healthcare Professional Quality Control Center. Most healthcare workers in primary healthcare institutions lacked sufficient awareness and knowledge in infection prevention and control. Multiple HAI-related safety hazards existed in key departments of most primary medical institutions. Conclusion After nearly a year of continuous monitoring on HAI, the primary sentinel medical institutions have established their own data on the incidence of HAI. The compliance rate and correct rate of hand hygiene, as well as the removal rate of surface pollutants from environmental objects are still relatively low in some medical medical institutions, and there is much room for improvement. There is still a significant gap in terms of HAI prevention and control in some primary medical institutions when referring to the standards.