OBJECTIVE  To establish a hospital-associated infection prevention and control system for use in a no-companion management mode, and to evaluate its application effect, thereby providing a reference for improving medical safety.

METHODS  A hospital-associated infection prevention and control system was developed for the no-companion mode, featuring standardized workflows, specialized personnel, a structured environment, and closed-loop supervision. Patients admitted to Xiamen Cardiovascular Hospital Xiamen University between 2016 and 2024 were enrolled in this study. Those admitted between 2016 and 2019 （traditional companion mode） served as the control group, while those admitted between 2020 and 2024 （no-companion mode with the newly implemented prevention and control system） served as the experimental group. The two groups were compared regarding key indicators, including the hospital-associated infection episode rate, prevalence rate of specific multidrug-resistant organism （MDRO） infections, incidence of "three-catheter" （central venous catheter, urinary catheter and ventilator）-associated infections, hospital-associated infection prevalence rate, environmental hygiene monitoring compliance rate and hand hygiene adherence rate.

RESULTS  The experimental group showed a lower hospital-associated infection episode rate （1.43%） and prevalence rate （2.71%） compared with the control group （P＜0.05）. The detection rates of specific MDRO infections exhibited an overall downward trend: methicillin-resistant Staphylococcus aureus （MRSA） （0.02%）, carbapenem-resistant Klebsiella pneumoniae （0.03%）, carbapenem-resistant Pseudomonas aeruginosa （0.01%）, vancomycin-resistant Enterococcus faecium （0%） and carbapenem-resistant Acinetobacter baumannii （0.01%）, all lower than those in the control group （P＜0.05）. The incidence rates of "three-catheter"-associated infections decreased: ventilator-associated pneumonia （VAP, 3.88‰）, central line-associated bloodstream infection （CLABSI, 0.12‰） and catheter-associated urinary tract infection （CAUTI, 0.86‰）, all lower than those in the control group （P＜0.05）. Meanwhile, the hand hygiene adherence rate and environmental hygiene monitoring compliance rate were 82.57% and 94.36%, respectively, both higher than those in the control group （P＜0.05）.

CONCLUSIONS  The hospital-associated infection prevention and control system developed for the no-companion mode is effective in clinical practice, significantly reducing the risk of hospital-associated infections. This systematic and practical framework offers a replicable model and theoretical basis for similar healthcare institutions adopting the no-companion management mode.