医护分类管理模式在多重耐药菌感染管理中的应用

 ——以《医院感染管理手册》的改良为例

程芬兰            

【摘要】对目前通行的《医院感染管理手册》进行改良，医护分别制订并实施监管，比较手册改良前后耐药菌知识考核合格率、手卫生执行率、医护人员手监测合格率、消毒效果（物表）监测合格率、MDROs构成比、医院感染率。以2012-2015年各年度数据相比较，耐药菌知识考核合格率（x² = 209.496，p＜0.001）、手卫生执行率（x²  = 158.561，p ＜ 0.001）、医护人员手监测合格率（x² = 23.229，p ＜0.001）、物体表面消毒效果监测合格率（x² = 158.561，p ＜ 0.001）均有显著上升。MDRO_s医院感染构成比改良后6.03%较在《医院感染管理手册》改良前MDRO_s医院感染构成比13.98%显著降低（x² = 18.141，p ＜ 0.001）。MDROs院内感染率0.07%较未改良之前MDROs院内感染率0.34%显著下降（x² = 59.165，p ＜ 0.001）。由此说明以《医院感染管理手册》医护分册管理为主实施医护分类管理模式对提高了医护人员对医院感染的警觉性和自觉性，降低了院内多重耐药菌的感染具有显著的作用。

【关键词】医院感染管理手册；改良；多重耐药菌；管理

The application of medical care classification management model in the management of multidrug-resistant bacteria infection-Taking the improvement of “The Handbook of Nosocomial Infections Management” as an example.Chen Fenglan, Qinghai province cardio-cerebral-vascular specialist hospital, Xining 810012,Qinghai,China

    【Abstract】 To Improving “The Handbook of Nosocomial Infections Management”, We divided this handbook into doctor’s volume and nurse’s volume, to comparison of manual modified resistant knowledge examination pass rate, the implementation rate of hand hygiene of medical staff hand, monitoring qualified rate, disinfection effect, the qualified rate of MDROs, the hospital infection rate between two parts. The annual data of 2012-2015 were compared, the resistant knowledge examination pass rate (x2 = 209.496, P < 0.001), hand hygiene rates (x2 = 158.561, P < 0.001), hand monitoring staff qualification rate (x2 = 23.229, P < 0.001), monitoring the surface disinfection effect rate (x2 = 158.561, P < 0.001) have increased significantly. The proportion of nosocomial infection in MDROs was 6.03%, was significantly lower than before the improvement of nosocomial infection management manual 13.98%, (x2 = 18.141, P < 0.001). MDROs nosocomial infection rate was significantly decreased than before the improvement, 0.07% and 0.34% respectively (x² = 59.165, P < 0.001). This indicates that the implementation of medical classification management mode based on the management of “The Handbook of Nosocomial Infections Management” medical has great improving the alertness and consciousness of hospital staff and reducing the infection of multidrug-resistant bacteria in hospital.

【Key  words】Handbook of Nosocomial Infections Management；Improvement；Multi drug resistant bacteria；Management