基于多部门协作的透明化监管模式在ICU多重耐药菌感染防控中的应用及其效果

Effect of transparent supervision model based on multi-department collaboration on prevention and control of multidrug-resistant organisms infections in ICU

  • 摘要:
    目的 探讨基于多部门协作的透明化监管模式在ICU多重耐药菌(MDROs)感染防控中的应用效果,以期为降低MDROs感染率提供参考。
    方法 选取阜阳市人民医院2022年1-12月入住ICU的1 354例患者为对照组,2023年1-12月入住ICU的1 336例患者为干预组。通过构建多部门参与的三级管理组织架构,利用信息化手段搭建透明化监管平台,对ICU患者MDROs感染进行实时监测、预警与干预,并比较干预前后ICU患者MDROs感染率、MDROs检出率、手卫生执行率、手卫生正确率、物体表面三磷酸腺苷(ATP)生物荧光检测清洁合格率、病原学送检率及MDROs核心防控措施执行率等指标的变化。
    结果 干预后,医院感染发生率、呼吸机相关肺炎发病率、MDROs感染率、耐碳青霉烯鲍曼不动杆菌感染发生率、送检阳性率分别为2.62%、1.31‰、0.97%、0.30%、27.66%,均较干预前降低(P<0.05);手卫生执行率、手卫生正确率、物体表面ATP生物荧光检测清洁合格率、抗菌药物治疗前病原学送检率、联合使用重点药物前病原学送检率、耐碳青霉烯类肠杆菌科细菌检出率、耐碳青霉烯铜绿假单胞菌检出率及MDROs核心防控措施执行率分别为95.86%、94.96%、77.78%、91.60%、98.29%、47.51%、39.37%及95.65%,均较干预前提高(P<0.05)。
    结论 基于多部门协作的透明化监管模式在ICU MDROs感染防控中的应用效果显著,能有效提高MDROs核心防控措施的落实,降低MDROs感染发生率。

     

    Abstract:
    OBJECTIVE  To explore the application effect of transparent supervision model based on multi-department collaboration in the prevention and control of multidrug-resistant organisms (MDROs) infections in the intensive care unit (ICU), with the aim of providing reference for reducing the infection rate of MDRO.
    METHODS  A total of 1 354 patients admitted to the ICU from Jan. to Dec. 2022 at Fuyang People's Hospital were selected as the control group, and 1 336 patients admitted to the ICU from Jan. to Dec. 2023 were selected as the intervention group. By constructing a three-tier management organizational structure involving multiple departments and utilizing information technology to establish a transparent supervision platform, real-time monitoring, early warning and intervention of MDROs infections in ICU patients were carried out. Changes in indicators such as the MDROs infection rate, MDROs detection rate, hand hygiene implementation rate, hand hygiene accuracy rate, adenosine triphosphate (ATP) biofluorescence detection cleanliness pass rate of object surfaces, pathogenic detection rate and implementation rate of core prevention and control measures for MDROs were compared before and after the intervention.
    RESULTS  After intervention, the incidence rate of hospital-associated infections, the incidence rate of ventilator-associated pneumonia, the incidence rate of MDROs infections, the incidence rate of carbapenem-resistant Acinetobacter baumannii infections and the positive rate of detected specimens were 2.62%, 1.31‰, 0.97%, 0.30% and 27.66%, respectively, all of which were lower than those before intervention (P<0.05). The hand hygiene implementation rate, the hand hygiene accuracy rate, the ATP biofluorescence detection cleanliness pass rate of object surfaces, the pathogenic detection rate before antibacterial drug treatment, the pathogenic detection rate before the combined use of key drugs, the detection rate of carbapenem-resistant Enterobacteriaceae, the detection rate of carbapenem-resistant Pseudomonas aeruginosa and the implementation rate of core prevention and control measures for MDRO were 95.86%, 94.96%, 77.78%, 91.60%, 98.29%, 47.51%, 39.37% and 95.65%, respectively, all of which were higher than those before intervention (P<0.05).
    CONCLUSIONS  The application of transparent supervision model based on multi-department collaboration in the prevention and control of MDROs infections in ICU shows significant results. It effectively enhances the implementation of core prevention and control measures for MDROs and reduces the incidence rate of MDROs infections.

     

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