摘要
目的了解某省二级及以上医疗机构导管相关血流感染(CRBSI)预防与控制实施现状,为医疗机构采取有效措施落实最佳证据,降低CRBSI提供参考依据。方法依据《血管导管相关感染预防与控制指南(2021版)》自行设计调查问卷,于2021年7月对某省二级及以上医疗机构CRBSI防控现状进行调查。结果共回收问卷87份,有效问卷79份,有效回收率90.8%。79所医疗机构的CRBSI监测工作(89.9%)和防控制度的制定(94.9%)基本落实,但制度更新滞后,仅78.7%予以更新。68.4%的医院关注了本院近3年的CRBSI发病率,关注中心静脉导管(CVC)、经外周静脉置入中心静脉导管(PICC)、透析导管相关感染发病率的医院较少,最低仅占38.9%。置管前评估(100%)和置管时置管者无菌操作技术(≥97.5%)落实较好。CRBSI防控指南落实的四个薄弱环节:仅有3.8%的医院选用含洗必泰醇浓度>0.5%的消毒剂进行皮肤消毒,54.4%的医院紧急状态下置管不能保证有效无菌操作技术时未在2 d内拔管,43.0%的医院存在病房内置管现象,43.0%的医院在使用导管输血后未在4 h内更换附加装置;26.6%的医院表明重症监护病房(ICU)是CRBSI发病率最高的科室。结论目前临床上CRBSI防控措施的落实与指南有一定差距,建议医务人员加强对最佳实践标准的认识,切实遵照指南落实感染防控工作,最大限度降低CRBSI的风险。
Objective To understand the implementation situation of prevention and control of catheter-related bloodstream infection(CRBSI) in second-level and above medical institutions in a province, so as to provide refe-rence for medical institutions to take effective measures to implement the best evidence and reduce CRBSI. Methods Questionnaire was designed base on Guideline for prevention and control of vascular catheter-related infection(2021 version), current situation of prevention and control of CRBSI in second-level and above medical institutions in a province in July 2021 was investigated. Results A total of 87 questionnaires were collected and 79(90.8%) were available. Monitoring work(89.9%) as well as formulation of prevention and control system(94.9%) for CRBSI in 79 medical institutions were basically implemented, but the system update was lagging behind, only 78.7% of them were updated. 68.4% of the hospitals paid attention to the incidence of CRBSI in the past three years, and few hospitals paid attention to the incidence of central venous catheter(CVC), peripherally-inserted central venous catheter(PICC) and dialysis catheter-related infection, with the lowest rate of 38.9%. Pre-catheterization evaluation(100%) and sterile manipulation technology of operator during catheterization(≥97.5%) were well implemented. There were four weak points in the implementation of CRBSI prevention and control guidelines: only 3.8% of hospitals used disinfectant containing chlorhexidine concentration >0.5% for skin disinfection, 54.4% of hospitals failed to pull out catheter within 2 days when emergency catheterization could not ensure effective aseptic operation technique, 43.0% of hospitals performed catheterization in wards, and 43.0% of hospitals failed to replace additional devices within 4 hours after using catheter blood transfusion;26.6% of hospitals indicated that intensive care unit was the department with the highest incidence of CRBSI. Conclusion At present, there is a certain gap between the implementation of
作者
戴凡
吴传芳
谭创
龙建华
DAI Fan;WU Chuan-fang;TAN Chuang;LONG Jian-hua(School of Nursing,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Nursing,Changsha Central Hospital,Affiliated to University of South China,Changsha 410004,China;Department of Nursing,Hunan Provincial People’s Hospital,Changsha 410002,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2022年第8期774-780,共7页
Chinese Journal of Infection Control
基金
湖南省自然科学基金科卫联合项目(2019JJ80052)
湖南省卫生健康委临床医学研究一般项目(20201976)
2022年长沙市中心医院(南华大学附属长沙中心医院)重点项目(YNKY202212)。
关键词
血管导管相关血流感染
最佳证据
实施现状调查
catheter-related bloodstream infection
best evidence
investigation on implementation situation
