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目的了解综合重症监护病房(ICU)住院患者医院感染发病率、器械相关感染发病率,分析相关危险因素,寻找有效预防与控制医院感染的关键环节及防控措施。方法采取前瞻性目标性监测方法,对2012年1月-12月入住ICU 48 h以上的294例患者进行调查,主管医生填写ICU患者相关信息调查表,医院感染管理专职人员进行追踪、感染判断及结果统计分析。结果 294例患者中,发生医院感染61例,78例次,医院感染发病率为20.75%,医院感染例次发病率为26.53%。患者日医院感染发病率为16.01‰,患者日医院感染例次发病率为20.47‰,经患者平均病情严重程度调整后的患者医院感染例次发病率为7.48%。呼吸机相关性肺炎(VAP)发病率为27.27‰,中心静脉相关血流感染发病率为6.58‰,导尿管相关泌尿道感染发病率为3.15‰。结论 ICU属于医院感染高危科室,在器械相关感染中,VAP感染发病率最高。需要通过监测不断发现问题,不断改进,加强对医务人员的医院感染防控知识培训、医务人员与医院感染专职人员密切沟通、医院感染控制措施的落实等降低ICU医院感染发病率及器械相关感染发病率。
Objective To understand the prevalence of nosocomial infection and the incidence of hospital-related infections in hospitalized patients in intensive care unit (ICU), analyze the related risk factors and find out the key links and prevention and control measures for effective prevention and control of nosocomial infections. Methods A prospective and targeted monitoring method was used to investigate 294 patients admitted to ICU for more than 48 hours from January to December in 2012. The competent doctor filled in the questionnaire about the related information of ICU patients and the staff of hospital infection management followed up, Results of statistical analysis. Results Among the 294 patients, 61 cases were hospitalized and 78 cases were hospitalized. The incidence of nosocomial infection was 20.75%. The incidence of nosocomial infections was 26.53%. The incidence of nosocomial infection was 16.01 ‰, the incidence of nosocomial infections was 20.47 ‰, and the incidence of nosocomial infections was 7.48% after adjustment for the average severity of patients. The incidence of ventilator-associated pneumonia (VAP) was 27.27 ‰, the incidence of central venous-related bloodstream infections was 6.58 ‰, and the incidence of urinary tract-related urinary tract infections was 3.15 ‰. Conclusions The ICU belongs to the high risk department of hospital infection. In the device-related infection, the incidence of VAP infection is the highest. We need to reduce the incidence of hospital-acquired infections and device-related infections in ICU by continuously identifying problems and continuously improving them. We also need to strengthen training in knowledge on prevention and control of nosocomial infections among medical staffs, close communication between medical staff and full-time hospital staff, and implementation of hospital infection control measures rate.