摘要
目的:监测腹部急诊外科医院内获得性感染的具体数据及分类情况,评估腹部急诊外科医院感染的主要危险因素,提高目标监测的质量,针对性制定可靠的预防措施,达到有效降低医院感染发生率的目的。方法:通过对2016年收集的临床资料进行有效监测及分析,将发现的主要感染类型进行单因素及多因素分析查找感染的危险因素,同时进行PDCA管理,将任务分解后预计2019年内完成。通过SPSS19.0对相关数据进行统计,以证实PDCA效果的有效性。结果:2016年患者综合医院感染发生率为7.91%,手术部位感染(SSI)为主要感染类型,感染率为3.6%。通过对临床资料进行收集分析发现,SSI的易感因素为:NNIS评分≥3的SSI发生率高于NNIS评分<3。差异有统计学差异(χ^2=12.687,P<0.05)。术前不合理应用抗菌药物SSI发生率高于术前合理应用抗菌药物的SSI发生率。差异有统计学差异(χ^2=9.092,P<0.05)。手术时间≥3h的SSI发生率高于手术时间<3h。差异有统计学差异(χ^2=9.087,P<0.05)。通过精准应用PDCA管理达到2019年的SSI发生率明显下降,由3.6%下降至1.33%(χ^2=3.565,P<0.05)。结论:NNIS评分≥3,术前不合理应用抗菌药物均能成为手术部位感染的危险因素,针对上述主要危险因素进行有效的PDCA管理,可以有效降低SSI发生率。
Objective:To monitor the specific data and classification of acquired infections in abdominal emergency surgery,to evaluate the main risk factors of hospital infections of abdominal emergency surgery,to improve the quality of target monitoring,and to formulate reliable preventive measures targeted to effectively reduce the occurrence of hospital infections.Methods:Through effective monitoring and analysis of the clinical data collected in 2016,the main types of infections found were analyzed by single-factor and multi-factor analysis to find the risk factors of infection,and PDCA management was carried out.The task was expected to be completed in 2019.Statistics of relevant data were conducted through SPSS19.0 to confirm the effectiveness of PDCA.Results:In 2016,the incidence of general hospital infections was 7.91%,with surgical site infection(SSI)as the main type of infection,accounting for 3.6%.Through the collection and analysis of clinical data,it was found that the susceptibility factors of SSI are:The incidence of SSI with NNIS score≥3 is higher than that with NNIS score<3;the difference was statistically significant(χ^2=12.687,P<0.05).The incidence of SSI with irrational use of antimicrobials before surgery is higher than that of SSI with reasonable use of antimicrobials before surgery;the difference was statistically significant(χ^2=9.092,P<0.05).The incidence of SSI with operation time≥3h is higher than that with operation time<3h;the difference was statistically significant(χ^2=9.087,P<0.05).Through the precise application of PDCA management,the incidence of SSI in 2019 dropped significantly from 3.6%to 1.33%(χ^2=3.565,P<0.05).Conclusion:NNIS score≥3,and irrational use of antimicrobials before surgery can be risk factors for infection of the surgical site.Effective PDCA management for the main risk factors mentioned above can effectively reduce the incidence of SSI.
作者
唐冠杰
池水晶
孙志德
TANG Guanjie;CHI Shuijing;SUN Zhide(The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China)
出处
《河北医学》
CAS
2021年第1期71-74,共4页
Hebei Medicine
基金
2019年河北省承德市科学技术研究与发展计划项目,(编号:201904A051)。
关键词
腹部急诊外科
目标性监测
医院感染
PDCA
Abdominal emergency surgery
Targeted monitoring
Hospital infection
PDCA
