宁夏地区医疗机构消毒质量监测与干预效果的研究

发布时间：2018-03-20 19:12

本文选题：消毒质量　切入点：医院感染　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1.通过对2011-2016年宁夏地区医疗机构消毒质量监测数据的整理分析,了解该地区医疗机构的清洗、消毒和灭菌质量,为相关政策法规、标准规范的修订提供依据。2.对银川部分医疗机构采取干预措施,比较干预前后消毒质量的变化,掌握消毒工作的薄弱环节,确定切实有效的改进措施,为加强医院感染控制提供参考依据。3.对院感发生关键环节手卫生进行现况调查,评估手卫生消毒质量及影响因素,找出重点人群和适宜的洗消方法,为更好的控制由手卫生问题引起的医院感染提供借鉴。方法:1.收集各市、县(区)疾病预防控制中心上报的2011-2016年各级医疗机构的监测数据,将这些数据进行录入、汇总、分析和总结。2.随机抽取宁夏银川市三级、二级、一级医疗机构各1家,以这3家医疗机构的医务人员作为干预研究对象,采取宣传培训、现场技术指导、领导座谈,结果反馈等综合干预措施,在干预前后进行问卷调查和消毒质量监测,对干预情况进行评价和分析,比较干预前后医院消毒水平的变化。3.随机抽取宁夏银川市三级、二级、一级医疗机构各1家,以这3家医疗机构的医务人员作为研究对象,通过问卷调查和手卫生监测,了解手卫生知识掌握情况,评价不同等级医院、不同岗位和不同手卫生方式的消毒效果。结果:1.2011-2016年宁夏地区医疗机构消毒质量监测共采样71765份,总合格率为92.32%,各年度消毒质量监测合格率差异有统计学意义(χ2=572.21,P0.001);不同等级医疗机构合格率的差别有统计学意义(χ2=1182.16,P0.001);紫外线灯和室内空气合格率较低,分别为89.71%和83.91%。2.干预前后问卷平均得分差异有统计学意义(t=65.13,P0.001);干预前后手术室空气(χ2=11.35,P0.001)、环境物体表面(P0.05)、手卫生(χ2=22.07,P0.001)、医疗器械(χ2=13.63,P0.001)、医疗用水(χ2=4.9,P0.05)合格率的差异有统计学意义;外科手(P0.05)、内镜(χ2=2.27,P0.05)合格率的差异无统计学意义。3.不同等级医院(F=11.99,P0.001)、不同科室(F=4.42,P0.05)手卫生知识得分差异有统计学意义。手卫生总体合格率为67.35%,不同等级医院(χ2=19.33,P0.05)、医生和护士(χ2=22.46,P0.05)、四种不同手卫生方式(χ2=37.57,F0.05)手卫生合格率差异均具有统计学意义。结论:1.一级以下医疗机构消毒质量较差,是今后消毒质量监测的重点,相关部门应加强监督检查力度,提高其消毒水平。2.紫外线灯和室内空气是宁夏地区医疗机构消毒工作的薄弱环节,应该进一步加强医院消毒管理,定期监测,改进消毒方法,改善消毒设备。3.采取宣传培训、现场技术指导、领导座谈和结果反馈等综合干预措施,可以提高医务人员消毒卫生知识水平,完善医院感染管理组织,健全消毒灭菌制度,增高消毒质量合格率。4.卫生手消毒是一种简便、快捷、强效的手卫生方式,在手部没有可见污染时,可以直接使用快速手消代替肥皂或洗手液洗手。
[Abstract]:Objective to analyze the monitoring data of disinfection quality of medical institutions in Ningxia during 2011-2016, and to understand the cleaning, disinfection and sterilization quality of medical institutions in Ningxia, which are related policies and regulations. The revision of standards and norms provides the basis for intervention measures for some medical institutions in Yinchuan, compares the changes in disinfection quality before and after intervention, grasps the weak links of disinfection work, and determines practical and effective improvement measures. To provide reference basis for strengthening nosocomial infection control. 3. To investigate the status of hand hygiene in the key link of nosocomial infection, to evaluate the quality of hand hygiene disinfection and its influencing factors, and to find out the key population and the appropriate method of disinfecting. To provide reference for better control of nosocomial infections caused by hand hygiene problems. Methods: 1. Collect the surveillance data reported by the Centers for Disease Prevention and Control of cities and Counties (districts) for 2011-2016 at all levels of medical institutions, and input and collect these data. Analysis and summary .2. random selection of three, two, and one medical institutions in Yinchuan, Ningxia. Take the medical personnel of these three medical institutions as the objects of intervention, take propaganda and training, on-site technical guidance, and lead discussions, Results feedback and other comprehensive intervention measures, questionnaire survey and disinfection quality monitoring were carried out before and after intervention, and the intervention situation was evaluated and analyzed, and the changes of hospital disinfection level before and after intervention were compared .3.The third and second levels of Yinchuan City were randomly selected. The medical staff of these three medical institutions were taken as the research objects. Through questionnaire survey and hand hygiene monitoring, the knowledge of hand hygiene was understood, and the hospitals of different grades were evaluated. Results 71765 samples were collected from the monitoring of disinfection quality of medical institutions in Ningxia from 2011 to 2016. The total qualified rate was 92.32, the difference of the qualified rate of disinfection quality monitoring was statistically significant (蠂 2 / 572.21 / P 0.001), the difference of qualified rate between different grades of medical institutions was statistically significant (蠂 ~ 2 / 2 = 1182.16 / P 0.001), the qualified rate of ultraviolet lamp and indoor air was lower than that of control group (P < 0.05). The average scores of questionnaire before and after intervention were 89.71% and 83.91.2.The average scores of questionnaire before and after intervention were statistically significant, the air of operating room before and after intervention (蠂 ~ 2 ~ 2 ~ (11.35)) P _ (0.001), the surface of environmental objects (P _ (0.05)), hand hygiene (蠂 ~ (2) ~ (22) 0.7p _ (0.001), medical instruments (蠂 ~ (213.63N) P _ (0.001)), medical water (蠂 ~ (2) (4.9N) P 0.05) were significantly different. There was no significant difference in the pass rate between the two groups (蠂 2 / 2.27 / P 0.05). 3. There were significant differences in the scores of hand hygiene knowledge in different grade hospitals (蠂 2 / 319.3n / P 0.05) and in different departments (P = 4.42 / P 0.05). The total pass rate of hand hygiene was 67.35, and that of hospitals of different grades (蠂 2 / 319.3n / P 0.05) was higher than that of other hospitals (蠂 ~ 2 / 319.3 / P = 0.05), and the scores of doctors and nurses were higher than those of other hospitals (蠂 ~ 2 / 319.3 / P = 0.05). (蠂 ~ 2 ~ 2 ~ (22.46) P _ (0.05)), four different hand hygiene methods (蠂 ~ (2)) (蠂 ~ (2)) (蠂 ~ (2)) ~ (37.57) F _ (0.05) had statistical significance. Conclusion: 1. The disinfection quality of medical institutions below grade one is poor. It is the key point of disinfection quality monitoring in the future. The relevant departments should strengthen supervision and inspection to improve the disinfection level. Ultraviolet lamp and indoor air are the weak links in disinfection work of medical institutions in Ningxia area, and hospital disinfection management should be further strengthened. Regular monitoring, improvement of disinfection methods, improvement of disinfection equipment, adoption of comprehensive intervention measures such as propaganda and training, on-site technical guidance, leadership talks and feedback of results can improve the knowledge level of disinfection and hygiene of medical personnel. Improve the hospital infection management organization, perfect the disinfection and sterilization system, increase the qualified rate of disinfection quality .4.The sanitary hand disinfection is a simple, fast and powerful hand hygiene method, when there is no visible contamination in the hand, Instead of soap or hand sanitizer, you can use quick hand sanitizers directly.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R187

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