醫(yī)護(hù)分類管理模式在多重耐藥菌感染管理中的應(yīng)用
?——以《醫(yī)院感染管理手冊(cè)》的改良為例
程芬蘭 ???????????
【摘要】對(duì)目前通行的《醫(yī)院感染管理手冊(cè)》進(jìn)行改良，醫(yī)護(hù)分別制訂并實(shí)施監(jiān)管，比較手冊(cè)改良前后耐藥菌知識(shí)考核合格率、手衛(wèi)生執(zhí)行率、醫(yī)護(hù)人員手監(jiān)測(cè)合格率、消毒效果（物表）監(jiān)測(cè)合格率、MDROs構(gòu)成比、醫(yī)院感染率。以2012-2015年各年度數(shù)據(jù)相比較，耐藥菌知識(shí)考核合格率（x2 = 209.496，p＜0.001）、手衛(wèi)生執(zhí)行率（x2 ?= 158.561，p ＜ 0.001）、醫(yī)護(hù)人員手監(jiān)測(cè)合格率（x2 = 23.229，p ＜0.001）、物體表面消毒效果監(jiān)測(cè)合格率（x2 = 158.561，p ＜ 0.001）均有顯著上升。MDROs醫(yī)院感染構(gòu)成比改良后6.03%較在《醫(yī)院感染管理手冊(cè)》改良前MDROs醫(yī)院感染構(gòu)成比13.98%顯著降低（x2 = 18.141，p ＜ 0.001）。MDROs院內(nèi)感染率0.07%較未改良之前MDROs院內(nèi)感染率0.34%顯著下降（x2 = 59.165，p ＜ 0.001）。由此說(shuō)明以《醫(yī)院感染管理手冊(cè)》醫(yī)護(hù)分冊(cè)管理為主實(shí)施醫(yī)護(hù)分類管理模式對(duì)提高了醫(yī)護(hù)人員對(duì)醫(yī)院感染的警覺性和自覺性，降低了院內(nèi)多重耐藥菌的感染具有顯著的作用。
【關(guān)鍵詞】醫(yī)院感染管理手冊(cè)；改良；多重耐藥菌；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