基于透明的医院感染最优指标集的研究

Research on optimal indicator sets of hospital infections based on transparency

  • 摘要: 目的 甄选出适宜公开透明的最优医院感染指标,促进医院感染管理方式的创新,提高医院监管的效率。方法 在前期研究筛选出的推荐公开报告的22个医院感染指标基础上设计问卷,选择二级和三级公立医院医院感染管理科专职人员作为调查对象,采用现场问卷调查的方式进行调查。结果 共调查来自全国16个省份的137名院感专职人员,其中75.91%具有副高及以上职称,67.88%从事院感工作5年及以上; 总的积极系数为83.03%,权威系数为0.88,肯德尔(Kendall)协调系数为0.037(χ2=213.467,P<0.001); 总的重要性评分排前三位的指标为"医务人员手卫生依从率"、"呼吸机相关性肺炎核心预防措施执行率"和"血液透析相关性血流感染发病率"; 适宜性评分排前三位的指标为"围手术期预防性合理使用抗菌药物依从率"、"医务人员手卫生依从率"、"治疗性抗菌药使用时病原学送检率"; 重要性评分和适宜性评分中指标的排秩有所不同; 二级和三级医院指标的重要性评分排秩之间以及适宜性评分排秩之间均略有不同。结论 本调查结果真实、科学、可靠,所确定的医院感染指标为最终实现透明监管提供了理论支撑和循证依据。

     

    Abstract: OBJECTIVE To select the optimal hospital infection indicators suitable for open and transparency so as to promote the innovation of management of nosocomial infections and improve the efficiency of supervision. METHODS The questionnaire was developed according to the 22 hospital infection indicators recommended for public reports which were screened in the previous study.The full-time administrators for hospital infection in secondary public hospitals or tertiary public hospitals were recruited as the study objects, and the onsite questionnaire survey was conducted. RESULTS A total of 137 full-time participants who came from 16 provinces were investigated, of whom 75.91% had sub-senior or senior professional title, and 67.88% were engaged in the hospital infection management for more than 5 years.The total active coefficient was 83.03%, the authoritative coefficient was 0.88, and the Kendall coefficient was 0.037 (χ2=213.467,P<0.001).The top three indicators by importance scoring were "hand hygiene compliance rate of medical staff", "implementation rate of core preventive measures of ventilator-associated pneumonia" and "incidence of hemodialysis-related bloodstream infection"; and the top three indicators by suitability scoring were "compliance rate of perioperative prophylactic rational use of antimicrobial drugs", "hand hygiene compliance rate of medical staff" and "etiological submission rate as therapeutic antibiotics were used".There was difference in the ranking order of indicators between the importance scoring and the suitability scoring.The ranking orders of indicators by importance scoring and by suitability scoring of the secondary hospitals slightly differed from those of the tertiary hospitals. CONCLUSION The results of this survey are credible, scientific and reliable, and the confirmed hospital infection indicators provide theoretical support and evidence-based basis for finally achieving the transparent supervision.

     

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