呼吸科住院感染患者菌种分布、相关因素及管理小组干预效果分析

目的探讨呼吸科住院感染患者菌种分布、相关因素及管理小组干预的效果。方法选取2011年11月-2014年11月呼吸科住院患者528例作为研究对象,其中78例确诊为院内感染患者作为院内感染组,450例未出现院内感染患者作为非院内感染组,统计院内感染组感染部位、菌种分布,并对比院内感染组和非院内感染组一般资料;将院内感染组随机分为观察组和对照组,各39例,对照组给予常规护理,观察组在常规护理基础给予管理小组干预,记录干预后两组管理质量及护理满意度。结果本组78例院内感染患者,73.1%为呼吸系统感染,15.4%为泌尿系统感染,11.5%为消化系统感染;78例患者共检出148株病原菌,革兰阴性菌占82.4%,以铜绿假单胞菌最为常见(34.5%)。多因素Logistic回归分析表明,年龄≥60岁(OR=2.61)、侵入性操作(OR=5.68)、抗生素不合理应用(OR=2.23)、住院时间≥15 d(OR=1.71)是呼吸科患者院内感染的独立危险因素。观察组干预后,医院人员管理、环境管理、器械管理及护理满意度评分均显著高于对照组(P0.05)。结论呼吸科住院感染患者以革兰阴性菌感染为主,与年龄、侵入性操作、抗生素不合理应用、住院时间有关,应加强呼吸科医院感染管理。

Distribution of Strains,Related Factors and Intervention Effect of Management Group in Patients with Nosocomial Infection in Department of Respiration

Objective Objective To investigate the distribution of strains,related factors and the intervention effect of the management group in patients with nosocomial infection in Department of Respiration.Methods 528 hospitalized patients in Department of Respiration between November 2011 and November 2014 were selected as the objects of study.Seventy-eight of these patients who were diagnosed with nosocomial infection were included in the nosocomial infection group and the rest were included in the non-nosocomial infection group.The sites of infection and distribution of strains in the nosocomial infection group were statistically analyzed.The general data of the two groups were compared.The nosocomial infection group was further divided into the observation group and the control group by the random number table method,with thirty-nine cases in each group.The control group was given routine intervention while the observation group was given intervention by the management group.The management quality and nursing satisfaction of the two groups after intervention were recorded.Results Of the seventy-eight patients in this study,73.08％ were cases of respiratory system infections,15.38％ urinary system infections and 11.54％ digestive system infections.148 strains of pathogens were detected in these patients.Gram-negative bacteria accounted for 82.43％ and pseudomonas aeruginosa was common(34.46％).Multivariate logistic regression analysis found that age ≥ 60 years old(OR=2.61,95％ CI:1.06 ～ 3.97),invasive operation(OR=5.68,95％ CI:2.83 ～ 8.54),improper use of antibiotics(OR =2.23,95％ CI:0.89 ～ 4.55) and hospitalization time ≥ 15 d(OR =1.71,95％ CI:1.03 ～ 3.94) were the independent risk factors for patients with nosocomial infection in Department of Respiration.After intervention,scores of satisfaction with hospital staff management,environmental management,equipment management and nursing in the observation group were significantly higher than those in the control group (P＜0.05).Conclusions Gram-negative bacteria infection is the main infection in a department of respiration and is related to age,invasive operation,irraional use of antibiotics and hospitalization time,so the control of nosocomial infection in a department of respiration should be strengthened.