基于信息化的管理模式对多重耐药菌医院感染防控质量的影响

doi:10.3969/j.issn.1004-583X.2025.04.009

摘要/Abstract

摘要：

目的分析探讨基于信息化的管理模式对多重耐药菌医院感染防控质量的影响。方法收集本院2022年1-12月期间实施常规的多重耐药菌感染防控管理的相关资料,设为对照组;另收集本院2023年1-12月期间实施基于信息化的管理模式后的相关资料,设为观察组。对比分析两组环境物体表面多重耐药菌检出情况、多重耐药菌医院感染发生情况、医护人员感染防控质量。结果观察组和对照组分别检测环境物体表面标本912份和856份。观察组环境物体表面多重耐药菌检出率为9.10%,对照组环境物体表面多重耐药菌检出率为27.69%,两组差异有统计学意义(P<0.05);观察组和对照组共有住院患者94519例次和83736例次。观察组多重耐药菌医院感染总发生率为0.45%,对照组多重耐药菌医院感染总发生率为0.49%,两组差异有统计学意义(P<0.05);观察组医护人员手部卫生、健康宣教、基础知识、环境物品消毒、仪器设备消毒、医疗废物管理、微生物送检、传染病管理、职业暴露预防与处置得分情况高于对照组,差异有统计学意义(P<0.05)。结论基于信息化的管理模式能有效降低医院感染发生率和多重耐药菌感染检出率,强化了医护人员的多重耐药菌防控措施的执行力,对多重耐药菌医院感染防控质量的提高具有积极作用,值得临床推广应用。

关键词: 感染控制, 交叉感染, 信息化, 管理模式, 多重耐药菌, 防控质量

Abstract:

Objective To analyze and explore the impact of information-based management mode on the quality of hospital infection prevention and control of multidrug-resistant bacteria. Methods Relevant data on the implementation of routine multidrug resistant bacterial infection prevention and control management in our hospital from January 2022 to December 2022 were collected as the control group. Additionally, relevant data after the implementation of information-based management mode in our hospital from January 2023 to December 2023 were included in the observation group. Detection of multidrug-resistant bacteria on the surfaces of two environmental objects, the occurrence of hospital infections caused by multidrug-resistant bacteria, and the quality of infection prevention and control among medical staff were compared between groups. Results A total of 912 and 856 surface specimens of environmental objects were detected in the observation group and control group, respectively. The detection rate of multidrug-resistant bacteria on the surface of environmental objects was 9.10% in the observation group, and 27.69% in the control group, showing a significant difference between groups (P<0.05). There were a total of 94, 519 and 83, 736 hospitalized patients in the observation group and control group, respectively. The total incidence of hospital infections caused by multidrug-resistant bacteria was 0.45% in the observation group, and 0.49% in the control group, showing a significant difference between groups (P<0.05). The scores of hand hygiene, health education, basic knowledge, environmental item disinfection, instrument and equipment disinfection, medical waste management, microbiological testing, infectious disease management, occupational exposure prevention and disposal of medical staff in the observation group were significantly higher than those of the control group (P<0.05). Conclusion The information-based management model can effectively reduce the incidence of hospital infections and the detection rate of multidrug-resistant bacterial infections, strengthen the execution of multidrug-resistant bacterial prevention and control measures by medical staff, and have a positive effect on improving the quality of multidrug-resistant bacterial hospital infection prevention and control. It is worthy of clinical promotion and application.

Key words: infection control, cross infection, informationization, management mode, multidrug resistant bacteria, prevention and control quality

中图分类号:

R183

汪胜, 柯有韬. 基于信息化的管理模式对多重耐药菌医院感染防控质量的影响[J]. 临床荟萃, 2025, 40(4): 344-348.

Wang Sheng, Ke Youtao. The impact of information-based management mode on the quality of hospital infection prevention and control of multidrug-resistant bacteria[J]. Clinical Focus, 2025, 40(4): 344-348.

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https://lchc.magtechjournal.com/CN/Y2025/V40/I4/344

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参考文献 20

[1]	Barzekar H, Ebrahimzadeh F, Luo J, et al. Adoption of hospital information system among nurses: A technology acceptance model approach.[J]. Acta Inform Med, 2019, 27(5):305-310. doi: 10.5455/aim.2019.27.305-310 pmid: 32210497
[2]	徐华, 孙建, 李卫光. 区域性医院感染管理信息化平台建设与发展[J]. 中国数字医学, 2023, 18(4):8-12.
[3]	Nicolas-Chanoine MH, Vigan M, Laouénan C, et al. Risk factors for carbapenem-resistant enterobacteriaceae infections: A French case-control-control study[J]. Eur J Clin Microbiol Infect Dis, 2019, 38(2):383-393.
[4]	周四萍, 赵艳群, 吴雪玲, 等. 医院感染信息化监测系统在多药耐药菌感染防控中的作用[J]. 中华医院感染学杂志, 2023, 33(4):633-636.
[5]	王颜颜, 查筑红, 林丹, 等. 贵州省2019年12所医疗机构医院感染监测平台过程类数据与结果类数据比较[J]. 中国感染控制杂志, 2023, 22(1):80-88.
[6]	马文晖, 王力红, 赵会杰, 等. 北京市27所三级综合医院医院感染管理现况调查[J]. 中华医院感染学杂志, 2022, 32(16):2533-2536.
[7]	Tomczyk S, Zanichelli V, Grayson ML, et al. Control of carbapenem-resistant enterobacteriaceae, acinetobacter baumannii, and pseudomonas aeruginosa in healthcare facilities: A systematic review and reanalysis of quasi-experimental studies[J]. Clin Infect Dis, 2019, 68(5):873-884. doi: 10.1093/cid/ciy752 pmid: 30475989
[8]	赵金红, 秦冰, 闫润楠, 等. 我国三级公立医院主要医院感染指标现状及趋势分析(2018-2020)[J]. 中国感染控制杂志, 2022, 21(6):524-531.
[9]	Logan LK, Nguyen DC, Scaggs Huang FA, et al. A multi-centered case-case-control study of factors associated with klebsiella pneumoniae carbapenemase-producing enterobacteriaceae infections in children and young adults[J]. Pediatr Infect Dis J, 2019, 38(5):490-495. doi: 10.1097/INF.0000000000002176 pmid: 30169484
[10]	吴晓琴, 廖书娟, 阚红侠, 等. 多重耐药菌感染信息化透明监管干预模式的效果[J]. 中国感染控制杂志, 2021, 20(8):704-710.
[11]	侯璐蒙, 李嘉嘉, 钟娟, 等. 集束化干预联合闭环管理对ICU多重耐药菌感染的防控效果[J]. 护理学杂志, 2022, 37(16):92-94.
[12]	Liu L, Feng Y, Tang G, et al. Carbapenem-resistant isolates of the klebsiella pneumoniae complex in western China: The common ST11 and the surprising hospital-specific types[J]. Clin Infect Dis, 2018, 67(suppl_2):S263-S265.
[13]	张倩, 卢瑞杰, 王新露. 闭环管理模式在ICU病房多重耐药菌医院感染预防中的应用[J]. 护理实践与研究, 2020, 17(24):47-50.
[14]	翟荣夏, 曹琪, 孙芹. 多重耐药菌信息化闭环管理干预对ICU感染防控效果及管理质量的影响[J]. 国际护理学杂志, 2024, 43(8):1484-1488.
[15]	王俊, 文建国, 张福来. 信息化监测新模式在医院多重耐药菌预防控制中的应用[J]. 实用预防医学, 2020, 27(4):463-466.
[16]	王娜, 吉慧聪, 周慧莹. 危急值全程信息化管理和持续质量改进在多重耐药菌感染患者中的应用[J]. 齐鲁护理杂志, 2020, 26(15):123-125.
[17]	杜明梅, 姚宏武, 刘伯伟, 等. 基于信息化的多重耐药菌感染防控管理与效果分析[J]. 中国数字医学, 2023, 18(4):18-23.
[18]	谭伟锋, 温明锋, 杨楚欣, 等. 基于医院信息平台的多重耐药菌报告系统设计与应用[J]. 中国卫生信息管理杂志, 2023, 20(5):774-778.
[19]	中华预防医学会医院感染控制分会, 中华医学会感染病学分会, 中国医院协会医院感染管理专业委员会, 等. 中国碳青霉烯耐药革兰阴性杆菌(CRO)感染预防与控制技术指引[J]. 中华医院感染学杂志, 2019, 29(13):2075-2080.
[20]	郑小琴, 王亚. 多重耐药菌防控措施正确实施的持续质量改进[J]. 中国基层医药, 2023, 30(12):1891-1894.

组别	例数	耐碳青霉烯类鲍曼不动杆菌	耐甲氧西林金黄色葡萄球菌	耐碳青霉烯类铜绿假单胞菌	耐碳青霉烯类肠杆菌科细菌	合计
观察组	912	19(2.08)	25(2.74)	17(1.86)	22(2.41)	83(9.10)
对照组	856	58(6.78)	91(10.63)	36(4.21)	52(6.07)	237(27.69)
χ²值		23.340	44.833	8.326	14.769	102.900
P值		0.000	0.000	0.004	0.000	0.000

组别	例数	耐碳青霉烯类鲍曼不动杆菌	耐甲氧西林金黄色葡萄球菌	耐碳青霉烯类铜绿假单胞菌	耐碳青霉烯类肠杆菌科细菌	合计
观察组	912	19(2.08)	25(2.74)	17(1.86)	22(2.41)	83(9.10)
对照组	856	58(6.78)	91(10.63)	36(4.21)	52(6.07)	237(27.69)
χ²值		23.340	44.833	8.326	14.769	102.900
P值		0.000	0.000	0.004	0.000	0.000

耐药菌	例数	耐碳青霉烯类鲍曼不动杆菌	耐甲氧西林金黄色葡萄球菌	耐碳青霉烯类铜绿假单胞菌	耐碳青霉烯类肠杆菌科细菌	合计
观察组	94519	188(0.20)	61(0.06)	66(0.07)	108(0.11)	423(0.45)
对照组	83736	185(0.22)	82(0.10)	77(0.09)	63(0.08)	407(0.49)
χ²值		0.658	12.117	1.810	4.356	5.937
P值		0.417	0.001	0.018	0.037	0.015

耐药菌	例数	耐碳青霉烯类鲍曼不动杆菌	耐甲氧西林金黄色葡萄球菌	耐碳青霉烯类铜绿假单胞菌	耐碳青霉烯类肠杆菌科细菌	合计
观察组	94519	188(0.20)	61(0.06)	66(0.07)	108(0.11)	423(0.45)
对照组	83736	185(0.22)	82(0.10)	77(0.09)	63(0.08)	407(0.49)
χ²值		0.658	12.117	1.810	4.356	5.937
P值		0.417	0.001	0.018	0.037	0.015

组别	例数	手部卫生	健康宣教	基础知识	环境物品消毒	仪器设备消毒	医疗废物管理	微生物送检	传染病管理	职业暴露预防与处置
对照组	66	73.82±2.34	74.62±3.53	72.62±3.25	72.64±3.16	72.46±3.45	71.53±3.26	72.47±2.18	73.46±3.63	71.63±2.52
观察组	71	83.38±1.86	85.81±2.25	84.53±2.33	82.53±2.54	81.35±3.62	82.46±2.64	83.56±2.75	84.47±2.87	83.26±2.64
χ²值		26.344	21.941	24.490	20.097	14.717	21.469	26.24	19.596	26.379
P值		0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000	0.000