【摘要】：目的探討集束化管理策略在多重耐藥菌(MDRO)管理中的應(yīng)用。方法 2013年7月1日起對(duì)某三甲綜合醫(yī)院住院患者M(jìn)DRO管理實(shí)施集束化干預(yù)措施,監(jiān)測(cè)常見(jiàn)MDRO感染/定植患者相關(guān)隔離措施的實(shí)施情況,2013年4—6月為干預(yù)前組,2013年7—9月為干預(yù)第1階段,2013年10—12月為干預(yù)第2階段,比較干預(yù)前后各項(xiàng)措施合格率及常見(jiàn)MDRO日感染率。結(jié)果 2013年4—12月共檢出非重復(fù)菌株3 430株。"接觸隔離"醫(yī)囑合格率干預(yù)前為78.14%,干預(yù)第2階段為95.95%;懸掛床旁隔離標(biāo)識(shí)、配置床旁速干手消毒劑、患者佩戴藍(lán)色腕帶合格率干預(yù)前分別為52.70%、66.89%、87.16%,干預(yù)第2階段均達(dá)100.00%。醫(yī)療用品及環(huán)境消毒、病床安置合格率干預(yù)前分別為23.65%、15.54%,干預(yù)第2階段分別為79.79%、77.66%。醫(yī)務(wù)人員手衛(wèi)生知識(shí)知曉率、依從率以及正確率干預(yù)前分別為69.70%、45.76%、76.35%;干預(yù)第2階段分別為90.23%、87.50%、94.58%;干預(yù)前及干預(yù)后各階段各項(xiàng)隔離措施實(shí)施的合格率比較,差異均有統(tǒng)計(jì)學(xué)意義(均P0.01)。干預(yù)前階段、干預(yù)第1階段和干預(yù)第2階段常見(jiàn)MDRO日發(fā)病率分別為3.24‰、2.63‰、2.20‰。結(jié)論應(yīng)用集束化管理策略對(duì)MDRO進(jìn)行監(jiān)測(cè)和干預(yù),各項(xiàng)隔離措施合格率提高,MDRO感染日發(fā)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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