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目的了解精神科病房实施综合质量改进措施前后的效果,为降低医院感染率提供依据。方法对2008年1月-2012年12月入住精神科>48 h的患者进行监测,将2008年1月-2009年12月设为改进前组,采用前瞻性监测与回顾性调查相结合的方式,将2010年1月-2012年12月设为改进后组,采用目标性监测方式,在改进前组感染控制措施的基础上,采取增加专业技术人员配备、改善患者住院环境、加强手卫生管理、加大培训力度及纳入专题研究等综合质量改进措施。结果质量改进措施实施前后,监测住院患者分别为441例和976例,感染率分别为11.79%和4.20%(P<0.05);漏报率由16.67%降至8.33%;抗菌药物使用率从39.23%降至23.05%(P<0.05);手卫生用品用量逐年上升。结论针对精神科医院感染的特点,开展目标性监测,落实综合质量改进措施,形成持续质量改进的良性循环,可有效预防医院感染的发生。
Objective To understand the effect of implementing comprehensive quality improvement measures in psychiatric wards before and after, so as to provide the basis for reducing the hospital infection rate. Methods From January 2008 to December 2012, patients admitted to the psychiatric department for> 48 h were monitored, and January 2008 - December 2009 were enrolled as the improvement group. The combination of prospective surveillance and retrospective investigation , January 2010 - December 2012 as the improved group, the use of targeted monitoring methods, improve the infection control measures in the former based on the group to increase the professional and technical personnel to improve the hospital environment for patients, to strengthen hand hygiene management , Intensify training and incorporate comprehensive quality improvement measures such as special studies. Results Before and after the implementation of quality improvement measures, 441 inpatients and 976 inpatients were monitored. The infection rates were 11.79% and 4.20% respectively (P <0.05), the false negative rate was decreased from 16.67% to 8.33%, and the rate of antibacterials utilization was from 39.23 % To 23.05% (P <0.05); hand hygiene supplies increased year by year. Conclusion In view of the characteristics of psychiatric hospital infection, we conducted targeted monitoring, implemented comprehensive quality improvement measures and formed a virtuous cycle of continuous quality improvement, which can effectively prevent the occurrence of nosocomial infections.