全国二级以上医疗机构三项医院感染管理质控指标的管理现况调查

Current status of management of three quality control indexes for management of hospital-associated infection in medical institutions above secondary level nationwide

  • 摘要:
    目的 调查医院感染发病(例次)率、医院感染现患(例次)率、医院感染漏报率三项医院感染管理质控指标(2015版)数据及使用情况、使用效果和存在的问题。
    方法 通过国家医院感染管理医疗质量控制中心开展的年度专业质控工作选取调研前三年(2018-2020年)连续三年参与上报医院的数据进行分析;通过网络问卷抽样调查评价以上三项院感质控指标使用情况。
    结果 不同级别、不同类型的医院三项指标使用率均>80%,医院感染发病(例次)率、医院感染漏报率2项指标,三级医院使用率高于二级医院,综合医院的指标使用率高于专科医院(P<0.05);而医院感染现患(例次)率指标,三级医院的指标使用率为96.01%,高于二级医院(90.73%),差异有统计学意义(P<0.05),综合医院的指标使用率(92.22%)高于专科医院(89.50%)(P=0.102);医院感染发病(例次)率的实施效果自评方面,不同级别及不同类型医院自评差异均有统计学意义(P<0.001);医院感染现患(例次)率和医院感染漏报率的实施效果自评,不同级别医院的差异有统计学意义(P<0.001)。
    结论 医院感染发病(例次)率、医院感染现患(例次)率、医院感染漏报率三项指标三年内整体稳定,使用情况、使用评价存在一定的差异,需要结合实际情况进行合理修订,更好地指导临床感控工作。

     

    Abstract:
    OBJECTIVE To investigate the data and usage, effectiveness and existing issues of three medical quality control indicators for hospital-associated infection management (2015 Edition), including hospital-associated infection incidence rate, hospital-associated infection prevalence rate and hospital-associated infection underreporting rate.
    METHODS Data from hospitals that participated in reporting for three consecutive years (2018-2020) prior to the survey were selected for analysis through the annual professional quality control work conducted by the National Nosocomial Infection Management and Quality Control Center. An online questionnaire-based sampling survey was conducted to evaluate the usage of the aforementioned three hospital-associated infection quality control indicators.
    RESULTS The usage rates of the three indicators were above 80% in hospitals of different levels and types. For the two indicators of hospital-associated infection incidence rate and hospital-associated infection underreporting rate, the usage rates were higher in tertiary hospitals than in secondary hospitals, and higher in general hospitals than in specialized hospitals (P < 0.05). For the hospital-associated infection prevalence rate indicator, the usage rate was 96.01% in tertiary hospitals, higher than that in secondary hospitals (90.73%), with a statistically significant difference (P < 0.05). The usage rate of such indicator was also higher in general hospitals (92.22%) than in specialized hospitals (89.50%) (P=0.102). Regarding self-evaluation of the implementation effectiveness of the hospital-associated infection incidence rate, statistically significant differences were found among hospitals of different levels and types (P < 0.001). For self-assessment of the implementation effectiveness of the hospital-associated infection prevalence rate and hospital-associated infection underreporting rate, statistically significant differences were found among hospitals of different levels (P < 0.001).
    CONCLUSIONS The three indicators, hospital-associated infection incidence rate, hospital-associated infection prevalence rate and hospital-associated infection underreporting rate, have been stable overall in the past three years. There are certain differences in their usage and evaluation. Reasonable revisions should be made based on actual situations to better guide clinical infection control work.

     

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