摘要
目的了解神经外科手术部位感染率及相关因素,评价持续质量改进(CQI)实施效果。方法与2010年4-9月及2010年10月-2011年4月分两个阶段对221例颅脑手术患者进行目标性监测,第1阶段主要了解手术部位感染率及相关因素;第2阶段将感染率及进行危险因素调整后的感染率反馈给手术者,应用CQI方法进行医院感染质量监控。结果第1阶段调整医师感染率为9.89%,第2阶段调整医师感染率为2.99%,两者差异有统计学意义(P<0.05);术前麻醉分级(ASA)>Ⅲ级、急诊手术、术前未用抗菌药物、污染切口的手术部位感染率分别为8.94%、7.69%、10.67%、12.50%,显著高于ASA<Ⅲ级、择期手术、术前使用抗菌药物、清洁切口的手术部位感染率(1.02%、1.28%、2.74%、3.87%),差异有统计学意义(P<0.05);而手术时间、植入物、百分位数、是否曾住ICU等感染影响因素差异无统计学意义。结论对手术部位感染进行目标性监测与分析,通过实施CQI方法进行医院感染质量监控,能有效降低手术部位感染的发生。
OBJECTIVE To understand the rate of surgical site infections in neurosurgery department and the related factor and evaluate the effect of continuous quality improvement （CQI）. METHODS Targeted surveillance of 221 patients undergoing brain surgery was performed by dividing them into two phases： Apr--Sep 2010 and Oct 2010 --Apr 2011; in the first phase, the main task was to understand the infection rate and related factors for the surgical site infections;in the second phase, the infection rates and the infection rates after the risk factors were adjusted were made feedback for the operator, and CQI method was applied to monitor the hospital infection quality. RESULTS The infection rate of adjusting the doctors was 9. 89% in the first phase, 2.99% in the second phase,the difference is statistically significant （P 〈 0. 05）; the surgical site infection rates of preoperative anesthesia score （ASA） greater than III , emergency surgery, postoperative surgery without using antibiotics, and contaminated incision were respectively 8.94%, 7.69%, 10.67%, and 12.50, significantly higher than 1.02%, 1.28%, 2.74% , and 3.87% of ASA less than III, elective surgery, preoPerative use of antibiotics, and cleaning the surgical incision , the differences were statistically significant （P〈0.05）; the differences in the influencing factors such as the operation duration, implants, percentile, and ICU stay were not statistically significant. CONCLUSION Targeted surveillance of the surgical site infections and CQI method applied for surveillance of nosoeomial infection quality can effectively reduce the surgical site infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第16期3534-3536,共3页
Chinese Journal of Nosocomiology
关键词
神经外科
手术部位感染
监测
分析
Neurosurgery department
Surgical site infection
Monitoring
Analysis
