ICU物体表面清洁消毒质量干预在多药耐药菌预防控制中的效果分析

发布时间：2018-09-18 08:03

【摘要】：目的探讨环境物体表面清洁消毒循证综合干预在重症监护病房(ICU)预防和控制多药耐药菌(MDROs)中的作用。方法 2013年1-3月ICU执行传统的物体表面清洁制度,医院感染管理科按常规监测,不作反馈;2013年4月-2014年3月制定有循证依据的干预措施指导临床进行日常环境清洁消毒工作,使用荧光标记、拭子培养监测物体表面的清洁消毒质量,运用PDCA循环管理模式持续提高病区的环境卫生清洁质量。结果通过持续干预,物体表面荧光标记清除率改善明显(P0.05),由干预前的39.17%上升至72.03%,其中医疗设备物体表面、高频接触卫生表面荧光标记清除率分别上升36.13%、33.81%;MDROs感染患者床单位终末消毒后MDROs阳性率从干预前的4.12%下降至1.08%,干预前后差异均有统计学意义(P0.05);MDROs每千住院日分离率呈下降趋势。结论 ICU建立以循证医学为基础的医院环境清洁策略和制度,并应用到实践中,可有效预防和控制MDROs感染的发生。
[Abstract]:Objective to investigate the role of Evidence-based intervention in the prevention and control of multidrug resistant bacteria (MDROs) in (ICU) of intensive care unit (ICU). Methods from January to March 2013, ICU implemented the traditional system of surface cleaning of objects, the hospital infection management department monitored it without feedback, and from April 2013 to March 2014, evidence-based interventions were developed to guide clinical routine environmental cleaning and disinfection. The quality of cleaning and disinfection on the surface of the object was monitored by means of fluorescence labeling and the PDCA circulation management model was used to continuously improve the quality of environmental hygiene in the disease area. Results after continuous intervention, the clearance rate of fluorescence labeling was improved significantly (P0.05), from 39.17% before intervention to 72.03%. The clearance rate of fluorescent labeling of high frequency contact hygiene surface was increased 36.13% and 33.81% respectively. The positive rate of MDROs decreased from 4.12% before intervention to 1.08% after disinfection of bed unit of MDROs infected patients. The difference before and after intervention was statistically significant (P0.05) the separation rate of MDROs per thousand hospitalization days showed a decreasing trend. Conclusion ICU can effectively prevent and control the occurrence of MDROs infection by establishing a hospital environment cleaning strategy and system based on evidence-based medicine and applying it to practice.
【作者单位】：广东省人民医院(广东省医学科学院)院感监测室;
【基金】：广东省科技计划基金资助项目(2012B031800162)
【分类号】：R187

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