集束化管理策略在多重耐药菌管理中的应用

发布时间：2019-03-05 07:20

【摘要】：目的探讨集束化管理策略在多重耐药菌(MDRO)管理中的应用。方法 2013年7月1日起对某三甲综合医院住院患者MDRO管理实施集束化干预措施,监测常见MDRO感染/定植患者相关隔离措施的实施情况,2013年4—6月为干预前组,2013年7—9月为干预第1阶段,2013年10—12月为干预第2阶段,比较干预前后各项措施合格率及常见MDRO日感染率。结果 2013年4—12月共检出非重复菌株3 430株。"接触隔离"医嘱合格率干预前为78.14%,干预第2阶段为95.95%;悬挂床旁隔离标识、配置床旁速干手消毒剂、患者佩戴蓝色腕带合格率干预前分别为52.70%、66.89%、87.16%,干预第2阶段均达100.00%。医疗用品及环境消毒、病床安置合格率干预前分别为23.65%、15.54%,干预第2阶段分别为79.79%、77.66%。医务人员手卫生知识知晓率、依从率以及正确率干预前分别为69.70%、45.76%、76.35%;干预第2阶段分别为90.23%、87.50%、94.58%;干预前及干预后各阶段各项隔离措施实施的合格率比较,差异均有统计学意义(均P0.01)。干预前阶段、干预第1阶段和干预第2阶段常见MDRO日发病率分别为3.24‰、2.63‰、2.20‰。结论应用集束化管理策略对MDRO进行监测和干预,各项隔离措施合格率提高,MDRO感染日发病率下降。
[Abstract]:Objective to explore the application of cluster management strategy in the management of multidrug resistant bacteria (MDRO). Methods from July 1, 2013, cluster intervention measures were carried out on MDRO management of inpatients in a three-tier general hospital to monitor the implementation of isolation measures for common MDRO infection / colonization patients. From April to June 2013, the patients in the pre-intervention group were selected as the pre-intervention group. July-September 2013 was the first stage of intervention, and October-December 2013 was the second stage of intervention. The qualified rate of measures before and after intervention and the daily infection rate of common MDROs were compared. Results A total of 3 430 non-repetitive strains were detected from April to December 2013. " The qualified rate of contact isolation was 78.14% before intervention and 95.95% in the second stage of intervention. The qualified rate of patients wearing blue wristband was 52.70% 66.89% 87.16% before intervention and 100.00% in the second stage of intervention. The qualified rates of medical supplies and environmental disinfection were 23.65%, 15.54% before intervention, 79.79% and 77.66% in the second stage of intervention, respectively. The awareness rate of hand hygiene knowledge, compliance rate and correct rate were 69.70%, 45.76%, 76.35% before intervention, 90.23%, 87.50%, 94.58% in the second stage of intervention, respectively, and that in the second stage of intervention were 90.23%, 87.50%, 94.58%, respectively. Before and after the intervention, the qualified rate of all kinds of isolation measures were statistically significant (P0.01). In the pre-intervention stage, the incidence of common MDROs in the first and second stages of intervention was 3.24 鈥，

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