中国东中西部部分省份三级公立综合医院感控工作现状及区域性特征

Current status of infection control in tertiary public general hospitals of selected provinces in eastern, central and western China and regional characteristics

  • 摘要: 目的 聚焦医院感染管理机制建设、院感相关人才建设、院感学科建设等因素,分析中国东、中、西部地区部分省份三级公立综合医院感染防控(简称感控)工作模式的现状及区域差异。方法 2024年8-9月在省级医院感染管理质控中心的协助下,便利抽取全国10个省(自治区、直辖市)和新疆生产建设兵团部分三级公立综合医院进行问卷调查,分析东、中、西部地区部分省份三级公立综合医院在感控工作模式上的相关变量,识别其在感控模式的差异。结果 东部地区省份在感控专职人员入职资质考核(78.89%)与定期培训频率(43.75%为月度培训)上处于较高水平,但具有明确性晋升路径的医院比例为17.78%; 以湖南为例的中部地区临床经验要求严格(86.36%),但管理制度建设尚不完善,42.42%仅部分关联学科建设; 西部地区省份晋升机制较完善(37.63%有明确路径),但入职资质准入宽松(62.37%无专业证书/考核要求)、国家政策执行率偏低(完全落实率55.32%)。结论 中国东中西部部分省份三级公立综合医院感控模式存在区域异质性,东部强于专业化管理但激励不足,中部重经验轻制度,西部资源受限但激励有效。

     

    Abstract: OBJECTIVE To focus on the factors such as construction of hospital-associated infections (HAIs) management mechanism, construction of relevant talents for HAIs control and construction of HAIs control discipline and investigate the current status of working patterns of infection control in tertiary public general hospitals across selected provinces in eastern ,central and western China,analyze the difference among the above regions. METHODS From Aug 2024 to Sep, 2024, with the assistance of provincial HAIs management quality control center, dozens of tertiary public general hospitals were conveniently extracted from 10 provinces (autonomous regions, municipality directly under the Central Government) and Xinjiang Production and Construction Corps, a questionnaire survey was conducted; the relevant variables for infection control working patterns of the tertiary public general hospitals were observed, and the differences in the infection control patterns were identified. RESULTS The infection control professionals (ICP) from provinces of eastern China were at relatively high levels of entry qualification assessment (78.89%) and frequency of regular training (43.75% monthly training) but 17.78% had sufficient clarity in career promotion pathways. The central region, taken Hunan Province as example, had strict requirements for clinical experience (86.36%), but had less comprehensive management system, with 42.42% having partial association with discipline development. The selected provinces of western Chine had more complete promotion mechanisms (37.63% had clear pathways), but had loose entry requirements (62.37% did not have professional certificates/assessment requirements) and lower implementation rate of national policies (with the complete implementation rate 55.32%). CONCLUSIONS There is regional heterogeneity in the infection control patterns among the tertiary public general hospitals from the selected provinces in eastern, central and western China. The provinces from eastern China are better at professional management but have less incentives, the provinces from central China stress on experience but neglect systems, and the provinces from western China are resource-constrained but have effective incentives.

     

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