APIC risk management and application for hospital-acqueird infections in ̔one hospital and multiple branches̓

OBJECTIVE To explore the application of multiple hospital branches management mode in control of risk of hospital-acqueird infections in a general hospital so as to move forward the infection control threshold.

METHODS The risk management closed loop, known as the infection index monitoring-risk assessment-risk response-effect evaluation-infection index monitoring, was adopted by People′s Hospital of Ningxia Hui Autonomous Region from Jan. to Jun. 2024. The risk of infection at different levels of hospital zones, disciplines, clinical departments and risk indices was evaluated by risk matrix method. The correlation between the risk indices of clinical department and the risk scores was observed, and the dynamic monitoring was carried out for the change of risk of infection in the clinical departments.

RESULTS The risk score was higher in the headquarter and Ningnan Branch than in the Xixia branch; the interquartile range (IQR) value from high to low was as follows: Xixia branch, hospital headquarter, Ningnan branch. The intensive care unit (ICU), nerve center and radiotherapy department were the disciplines at extremely high risk of infection. The ICU, cardiac vascular surgery department and gastroenterology department of the hospital headquarters, the ICU, neurosurgery department and neurology department of Ningnan branch and the ICU and cardiac vascular surgery department of Xixia branch were the departments at extremely high risk of infection. The etiological submission rate before drug therapy, implementation of prevention measures for multidrug-resistant organisms (MDROs), cleaning and disinfection and missing report of hospital-acqueird infection cases were the major supervision indices. The absolute values of Spearman related coefficient between clinical department risk scores and 4 indices-including the isolation rate of MDROs and the incidence of hospital-acqueird infection was greater than 0.5.

CONCLUSION The risk management closed loop that is applied in the ′one hospital and multiple branches′ medical institution may facilitate the dynamic monitoring, assessment and intervention the high-risk hospital branches, disciplines, departments and indices, and boost the capability of risk management of infections in medical institutions.