感染控制干预人员监督管理对患者手术感染的影响分析

Influence of infection control and supervision and management from intervention staff to surgical infections in patients

  • 摘要: 目的 探讨感染控制干预人员监督管理对患者手术感染的影响,以有效预防医院感染的发生。方法 选取2011年7月-2013年6月和2013年7月-2015年6月医院同一手术室进行手术的患者分为对照组和干预组,干预组1 546例、对照组1 512例,两组患者具有相同的医护人员,对照组给予常规处理,干预组由感染控制干预人员进行监督管理,比较两组医务人员手卫生执行率,患者术后感染率及抗菌药物使用时间,术前10 min、手术开始后10、60 min及手术结束时室内细菌变化、病原菌分布。结果 医护人员手卫生执行率对照组为60.38%,低于干预组97.83%;术后患者感染率干预组为0.91%;低于对照组8.00%;干预组患者抗菌药物使用时间为(2.23±0.42)d,短于对照组患者(4.88±1.21)d;两组以上指标比较,差异均有统计学意义(P<0.01);干预组在各个时间段手术室内细菌数均显著低于对照组手术室,差异均有统计学意义(P<0.01);干预组和对照组感染患者各分离出病原菌14株和121株,感染病原菌前3位均主要为大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌。<目的 设置感染控制干预人员后,可明显降低手术室各时间段细菌数,缩短术后抗菌药物的使用时间及提高手卫生执行率,降低手术患者的医院感染率。

     

    Abstract: OBJECTIVE To investigate the influence of infection control and supervision and management from intervention staff to surgical infections in patients, in order to prevent hospital infections effectively. METHODS Patients underwent surgery in the same operation room from Jul. 2011 to Jun. 2013 and from Jul. 2013 to Jun. 2015 were selected and divided into control group and intervention group, 1546 cases in the observation group and 1512 cases in the control group, two groups of patients with same medical personnel. The control group was given conventional treatment, and the intervention group was supervised and managed by the infection control intervention staff. Hand hygiene compliance rate of two groups medical personnel, infection rate of patients and antimicrobial drug use time were compared between the two groups. The indoor change of bacteria and pathogenic bacteria distribution at 10 minutes before operation, 10 min and 60 min of operation and the end of operation were compared. RESULTS The hand hygiene execution rate of medical staff in control group was 60.38%, which was lower than that in intervention group 97.83%. The infection rate after operation in control group was 0.91%, and intervention group 8.0%. The antimicrobial drug use time in intervention group was (2.23±0.42)d, which was shorter than control group (4.88±1.21)d . All the comparison above showed significant difference (P<0.01). Bacteria amount in interior of operation room in all time periods of intervention group was significantly lower than control group (P<0.01); A total of 14 strains of pathogens were isolated from intervention group and control group 121 strains, and the top three were Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. CONCLUSION The number of bacteria in the operation rooms can be significantly reduced by infection control intervention staff, which could also shorten the time of using antimicrobial agents and improve the implementation rate of hand hygiene, so as to reduce the incidence of hospital infections in patients with surgery.

     

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