流程再造模式对提高多部门参与多重耐药菌感染管理中的效果分析

目的:分析流程再造模式对提高多部门参及多重耐药菌(Multidrug-resistant bacterial,MDRB)感染管理中的效果,为指导医院多部门协作管理防控MDRB感染提供参考。方法:抽取2015年7月—2016年6月间MDRB感染患者110例资料为流程再造前组,另抽取2016年7月—2017年6月间流程再造后MDRB感染患者106例患者为流程再造后组;比较和分析流程再造多学科协作模式前后发现医院内MDRB感染报告时间、院内感染的检出率、院内感染发生率,以及比较和分析医务人员对MDRB的知晓率及防控措施依从性差异;标本的送检率、抗菌药物的使用率及DDDs的差异。结果:流程再造后组患者所在病区接收到从检验科发出的MDRB报告的时间明显早于流程再造前组(P<0.05),MDRB的检出率、医院感染率均低于流程再造前组(P<0.05),医务人员对MDRB的知晓率及防控措施的依从性均高于流程再造前组(P<0.05);流程再造后组标本的送检率高于流程再造前组,而抗菌药物使用率、使用强度(DDDs值)均低于流程再造前组。结论:流程再造模式的应用提高了各部门的参与度,也提高了院内感染管理的效率。

Effectiveness Analysis of Process Reengineering model on Improving Multisector participation and management of MDRB Infections

Objective:To analyze the effectiveness of the process reengineering model on improving the management of multidrug-resistant bacterial(MDRB)infection,and to provide a reference for the guidance of multi-department collaborative management and prevention of MDRB infection in hospitals.Methods:Data of 110 patients with MDRB infection from July 2015 to June 2016 were selected as the pre-process reengineering group,and 106 patients with MDRB infection from July 2016 to June 2017 were selected as the post-process reengineering group.The MDRB infection reporting time,nosocomial infection detection rate and nosocomial infection incidence were compared and analyzed before and after the multi-disciplinary collaboration model of process reengineering,and the differences in the awareness rate of MDRB among medical staff and the compliance of prevention and control measures were compared and analyzed;the difference of medical personnel's awareness rate of MDRB and compliance of prevention and control measures.and the difference in the rate of sample submission,the utilization rate of antibiotics and DDDs were compared and analyzed too.Results:The patients of post-process reengineering group in the ward after receiving the MDRB from clinical laboratory report time obviously earlier than those of pre-process reengineering group(P<0.05),the detection rate of MDRB,nosocomial infection rate are lower than those of pre-process reengineering group(P<0.05),medical staff awareness and prevention and control measures of MDRB adherence were higher than pre-process reengineering group(P<0.05).Conclusion:The application of the process reengineering model can improves the participation of all departments and the efficiency of nosocomial infection management.