摘要
目的评价增加手消毒剂用量对综合ICU医院感染发生率的影响,以提高医务人员手卫生依从率。方法2009年1月-2012年12月入住综合ICU>48h的全部住院患者进行医院感染前瞻性监测,并进行干预前后对照研究,2009年1-12月为基线调查,前瞻性、主动监测相关指标,不主动推行干预;2010年为过渡期,逐步推广干预措施;2011年1月-2012年12月全面实施干预措施;包括加强手卫生培训、配备方便充足的手消毒剂、监督检查、每季度从药剂科调阅手消毒剂的使用并向临床反馈结果等。结果共收集2 577例患者资料,感染211例,感染率8.19%;基线调查阶段综合ICU医院感染率为10.75%,实施干预措施后,医院感染发病率下降至4.17%,干预前后医院感染率比较差异有统计学意义(R=2.771,P<0.05);手消毒剂领用量及每病床手消毒剂使用量从2009年的5 900ml、4.75ml/d提高至2012年的106 800ml、41.88ml/d,分别上涨了17.10倍及7.82倍。结论 ICU是医院感染的高危科室,通过干预措施提高手消毒剂用量可以降低医院感染的发生。
OBJECTIVE To evaluate the effect of increase of hand disinfectants dosage on the incidence of nosocomi -al infections in the general ICU so as to improve the hand hygiene compliance of health care workers .METHODS The prospective surveillance of the nosocomial infections was carried out for all the patients who were hospitalized the general ICU for more than 48 hours from Jan 2009 to Dec 2012 ,then the controlled study was conducted be-fore and after the intervention ;the baseline survey ,prospective ,and initiative surveillance were performed from Jan 2009 to Dec 2009 ,and the intervention was not actively carried out ,while the intervention measures were gradually promoted during the transitional period of 2010 and were fully implemented from Jan 2011 to Dec 2012 , including the enhancement of hand hygiene training ,equipping with adequate hand disinfectants ,supervision and checking up , and review of parallel feedbacks of use of hand disinfections from the pharmacy department . RESULTS The data were collected from 2 577 patients ,211 cases had the infections ,with the infection rate of 8 .19% .The incidence of nosocomial infections was 10 .75% in the general ICU during the baseline survey stage and dropped to 4 .17% after the implementation of the intervention measures ,and there was significant difference in the incidence of nosocomial infections before and after the intervention （R= 2 .771 ,P〈 0 .05） .The planned con-sumption of the hand disinfectants increased from 5 900 ml in 2009 to 106 800 ml in 2012 ,while the actual con-sumption of the hand disinfectants per bed day increased from 4 .75 ml/d in 2009 to 41 .88/d ml in 2012 ,raised by 17 .10 times and 7 .82 times ,respectively .CONCLUSION The ICU is the department at high risk of nosocomial in-fections ,and it is necessary to increase the consumption of hand disinfectants through the intervention measures so as to reduce the incidence of nosocomial infections .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第6期1421-1423,共3页
Chinese Journal of Nosocomiology
基金
湖北省自然科学基金资助项目(2013CBF144)
关键词
手消毒剂
重症监护病房
医院感染
Hand disinfectant
Intensive care unit
Nosocomial infection
