外来医疗器械管理对骨科手术部位感染预防效果的评价
发布时间：2018-12-17 23:09
【摘要】：目的研究外来医疗器械在预防某三级甲等医院骨科手术部位感染的效果。方法采用流行病学类试验的研究方法,开展干预前后比较。2014年1月1日-2015年12月31日,对骨科腰椎手术、关节置换术(膝或髋关节)开展手术部位感染前瞻性、目标性监测,了解手术部位感染发生率;抽检上述两类手术的外来医疗器械,评价清洗质量;2016年1月1-2016年12月31日,采取干预措施(外来医疗器械集中清洗、灭菌)、提高器械清洗合格率,根据干预前后的各项监测指标评价手术部位感染预防效果。结果 2014年1月1日-2016年12月31日共行腰椎手术、关节置换术(膝或髋关节)1 825台;研究期间,1 825例腰椎手术、关节置换术(膝或髋关节)的手术部位感染率为1.8%,通过采取干预措施,SSI从1.8%下降至0.3%,差异有统计学意义(P0.05),相对危险度(RR值)及95%置信区间(95%CI)为0.172(0.040~0.736)。器械清洗合格率从干预前28.7%上升至85.0%,差异有统计学意义(χ2=33.835,P0.05)。术后患者发热平均时长从干预前(4.11±1.18)d下降至干预后(3.01±0.99)d,差异有统计学意义(t=14.141,P0.05);术后3日发热患者比例从干预前52.4%下降至40.7%,差异有统计学意义(χ~2=64.707,P0.05);抗菌药物使用强度从干预前46.66DDDs/百床日下降至干预后31.22DDDs/百床日;抗菌药物使用时长从416.67天/千床日下降至272.73天/千床日。结论通过规范外来医疗器械的管理,提高了手术器械清洗质量,并且通过多项评价指标监测数据的变化,全面、综合评价规范外来医疗器械管理的效果,从而为管理层制定相关规范提供更多的数据支持。
[Abstract]:Objective to study the effect of external medical devices on preventing infection of orthopedic surgery site in Grade 3A Hospital. Methods from January 1, 2014 to December 31, 2015, the surgical site infection of orthopedic lumbar vertebrae surgery, arthroplasty (knee or hip joint) was prospectively studied. Objective monitoring to understand the incidence of infection in the surgical site; The external medical instruments of the above two types of surgery were selected and the cleaning quality was evaluated. From January 1 to December 31, 2016, intervention measures (centralized cleaning and sterilization of external medical devices) were taken to improve the qualified rate of cleaning equipment, and to evaluate the preventive effect of surgical site infection according to the monitoring indexes before and after intervention. Results from January 1, 2014 to December 31, 2016, a total of 1 825 lumbar vertebrae operations were performed with arthroplasty (knee or hip joint). During the study period, the infection rate of arthroplasty (knee or hip joint) was 1.8% in 1 825 cases of lumbar surgery. The SSI decreased from 1.8% to 0.3% through intervention (P0.05). The relative risk (RR) and 95% confidence interval (95%CI) were 0.172 (0.040 卤0.736). The qualified rate of instrument cleaning increased from 28.7% to 85.0%, the difference was statistically significant (蠂 2, 33.835, P 0.05). The average duration of postoperative fever decreased from (4.11 卤1.18) days before intervention to (3.01 卤0.99) days after intervention, and the difference was statistically significant (t = 14.141). The proportion of fever patients decreased from 52.4% before intervention to 40.7, the difference was statistically significant (蠂 ~ 2 ~ (2) 64.707), the intensity of antimicrobial drug use decreased from one hundred bed days before intervention to one hundred bed days in 31.22DDDs/ after intervention. The duration of antimicrobial use decreased from 416.67 days per thousand bed days to 272.73 days per thousand bed days. Conclusion by standardizing the management of external medical devices, the cleaning quality of surgical instruments is improved, and the effect of standardizing the management of external medical devices is comprehensively evaluated by monitoring the change of data of many evaluation indexes. In order to provide more data support for management to formulate relevant specifications.
【作者单位】： 北京医院国家老年医学中心医院感染管理处;北京大学人民医院感染管理办公室;北京医院国家老年医学中心医院供应室;北京医院国家老年医学中心医院手术麻醉科;北京协和医院急诊科;
【基金】：北京医院科研科技新星基金资助项目(BJ-2016-04) 中美新发和再发传染病合作基金资助项目(5U2GGH000018)
【分类号】：R687
，
本文编号：2384927
[Abstract]:Objective to study the effect of external medical devices on preventing infection of orthopedic surgery site in Grade 3A Hospital. Methods from January 1, 2014 to December 31, 2015, the surgical site infection of orthopedic lumbar vertebrae surgery, arthroplasty (knee or hip joint) was prospectively studied. Objective monitoring to understand the incidence of infection in the surgical site; The external medical instruments of the above two types of surgery were selected and the cleaning quality was evaluated. From January 1 to December 31, 2016, intervention measures (centralized cleaning and sterilization of external medical devices) were taken to improve the qualified rate of cleaning equipment, and to evaluate the preventive effect of surgical site infection according to the monitoring indexes before and after intervention. Results from January 1, 2014 to December 31, 2016, a total of 1 825 lumbar vertebrae operations were performed with arthroplasty (knee or hip joint). During the study period, the infection rate of arthroplasty (knee or hip joint) was 1.8% in 1 825 cases of lumbar surgery. The SSI decreased from 1.8% to 0.3% through intervention (P0.05). The relative risk (RR) and 95% confidence interval (95%CI) were 0.172 (0.040 卤0.736). The qualified rate of instrument cleaning increased from 28.7% to 85.0%, the difference was statistically significant (蠂 2, 33.835, P 0.05). The average duration of postoperative fever decreased from (4.11 卤1.18) days before intervention to (3.01 卤0.99) days after intervention, and the difference was statistically significant (t = 14.141). The proportion of fever patients decreased from 52.4% before intervention to 40.7, the difference was statistically significant (蠂 ~ 2 ~ (2) 64.707), the intensity of antimicrobial drug use decreased from one hundred bed days before intervention to one hundred bed days in 31.22DDDs/ after intervention. The duration of antimicrobial use decreased from 416.67 days per thousand bed days to 272.73 days per thousand bed days. Conclusion by standardizing the management of external medical devices, the cleaning quality of surgical instruments is improved, and the effect of standardizing the management of external medical devices is comprehensively evaluated by monitoring the change of data of many evaluation indexes. In order to provide more data support for management to formulate relevant specifications.
【作者单位】： 北京医院国家老年医学中心医院感染管理处;北京大学人民医院感染管理办公室;北京医院国家老年医学中心医院供应室;北京医院国家老年医学中心医院手术麻醉科;北京协和医院急诊科;
【基金】：北京医院科研科技新星基金资助项目(BJ-2016-04) 中美新发和再发传染病合作基金资助项目(5U2GGH000018)
【分类号】：R687
，
本文编号：2384927
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