基于三级网络网底管理模式的医院感染监控队伍管理体系构建与效果评价

 目的 探讨基于医院感染管理三级网络网底管理模式下医院感染监控医生、护士队伍建设及其在医院感染管理中的作用。方法 采取科室推荐与个人自荐相结合方式选拔出医院感染监控医生与护士，通过明确职责、构建系统化培训、量化履职考核标准，以及月度200元专项津贴、职称晋升优先等激励待遇强化监控人员队伍的管理，比较2014—2018年医院感染监控队伍建立前后医院感染管理监测指标情况，评价成效。结果 全院设立医院感染监控医生54名，护士64名。随着管理的不断深入和精细化，监控医护人员得分显著提高，全院医院感染发生率由设立前的2.41%下降至1.17%，医院感染漏报率由20.67%下降至8.40%，多重耐药菌感染发现率由0.27%下降至0.12%，手卫生依从率由38.70%提高至58.25%，抗菌药物使用前微生物标本送检率由41.18%提高至74.08%，呼吸机相关肺炎及导尿管相关泌尿道感染发病率分别由10.47‰、3.11‰下降至2.42‰、1.13‰，差异均有统计学意义（均P<0.05）。结论 基于医院感染管理三级网络网底组织实施创新管理模式，能够有效提升医院感染监控医生与护士的积极性，对于带动全院做好医院感染管理工作，提升医院感染管理质量具有积极作用。

Establishment and effect assessment of management system of healthcare-associated infection monitoring team based on bottom management model of three-level network

Objective To explore the establishment and effect of healthcare-associated infection (HAI) monitoring team of clinicians and nurses based on bottom management model of three-level network in HAI management. Methods The combination of department recommendation and self-recommendation was adopted to select clinicians and nurses as monitoring staff, through defining responsibility, building systematic training, quantifying perfor-mance evaluation standards, monthly special allowance of 200 Yuan, title promotion priority and other incentive treatment, management of monitoring staff team was strengthened, HAI management monitoring indexes before and after the establishment of HAI monitoring team from 2014 to 2018 was compared, effectiveness was assessed. Results A total of 54 HAI control clinicians and 64 nurses were set up in the whole hospital. With the deepening and refinement of management, the scores of monitoring medical staff has improved significantly, incidence of HAI decreased from 2.41% before setting up to 1.17% after setting up, missing reporting rate of HAI decreased from 20.67% to 8.40%, isolation rate of multidrug-resistant organisms decreased from 0.27% to 0.12%, hand hygiene compliance increased from 38.70% to 58.25%, specimen detection rate prior to antimicrobial use increased from 41.18% to 74.08%, incidence of ventilator-associated pneumonia and catheter-related urinary tract infection decreased from 10.47‰ and 3.11‰ to 2.42‰ and 1.13‰ respectively, differences were all significant (all P<0.05). Conclusion Based on bottom management model of three-level network in HAI management, implementation of innovative management mode can effectively improve the enthusiasm of clinicians and nurses in HAI monitoring, which play a positive role in promoting HAI management and improving the quality of HAI management in the whole hospital.