A new management mode for the prevention and control of multidrug-resistant organisms in a tertiary hospital
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1.Department of Healthcare-associated Infection Management, The People's Hospital of Liupanshui City, Liupanshui 553000, China;2.Department of Hospital Office, The People's Hospital of Liupanshui City, Liupanshui 553000, China;3.Department of Neurosurgery, The People's Hospital of Liupanshui City, Liupanshui 553000, China;4.Department of Laboratory Medicine, The People's Hospital of Liupanshui City, Liupanshui 553000, China

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R197.323.4

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    Abstract:

    Objective To explore the application effect of risk assessment combined with plan-do-check-action (PDCA)cycle in the prevention and control of multidrug-resistant organism (MDRO) infection. Methods Relevant data of targeted monitoring on MDROs of "five categories and seven types" in a tertiary first-class hospital from July 2019 to June 2020 were selected. The pre-intervention stage was from July to December, 2019, and the post-intervention stage was from January to June, 2020. Based on risk assessment results in 2019, the PDCA cycle method was introduced to intervene and manage the detection of MDROs and the implementation of prevention and control measures. The detection of MDROs and the implementation rate of prevention and control measures before and after the intervention were compared. Results A total of 124 and 129 patients before and after the intervention were included respectively. After intervention, the pathogen detection rate before antimicrobial therapy was higher than before intervention (39.43% vs 33.13%, P < 0.001). The total implementation rate of MDRO prevention and control measures after implementing risk assessment combined with PDCA cycle intervention was 82.83%, which was higher than before the intervention (61.75%), with statistically significant difference (P < 0.05). After intervention, the implementation rates of 8 measures increased with statistically significant differences (all P < 0.05) compared to before intervention, including awareness of MDRO prevention and control measures, critical value reports, giving isolation medical orders, fluorescent monitoring on cleaning and disinfection of bed units, hand hygiene before and after operation, early handover about MDRO, notification of receiving departments to take isolation measures, and final disinfection. The detection rate of MDROs after intervention was 8.08%, which was lower than before intervention (10.31%), with statistically significant difference (P < 0.05). Detection rate of carbapenem-resistant Acinetobacter baumannii (CRAB) decreased from 60.78% to 48.13%, and detection rate of multidrug-resistant (MDR)/extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) decreased from 35.35% to 22.90% after intervention, with both differences statistically significant (both P < 0.05). Conclusion Risk assessment combined with the PDCA cycle can improve the implementation rate of MDRO prevention and control measures, so that the MDRO detection rate can be reduced even with increased pathogenicity detection rate before antimicrobial therapy.

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陈美利,景照峰,黄合田,等.某三级综合医院多重耐药菌防控管理新模式探讨[J].中国感染控制杂志英文版,2023,(8):925-931. DOI:10.12138/j. issn.1671-9638.20234240.
Mei-li CHEN, Zhao-feng JING, He-tian HUANG, et al. A new management mode for the prevention and control of multidrug-resistant organisms in a tertiary hospital[J]. Chin J Infect Control, 2023,(8):925-931. DOI:10.12138/j. issn.1671-9638.20234240.

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  • Received:March 21,2023
  • Revised:
  • Adopted:
  • Online: April 28,2024
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