依托信息化手段构建合理高效的医院感染管理机制

目的 探索一种科学、客观、高效的医院感染管理机制,提高医院感染管理质量。 方法 依托蓝蜻蜓医院感染管理系统、医院信息系统(HIS)、临床检验信息系统(LIS)、医院影像系统(PACS)、电子病历系统(EMR)、移动护理(PDA)、医院办公系统(OA),建立一套科学化的医院感染管理质量改进体系,并对应用信息化前后医院感染病例漏报率、多重耐药菌防控措施落实率、医院感染知识培训参学率、器械相关医院感染发病率、医院感染督查、传染病监管、消毒灭菌效果监测结果的时效性进行比效。 结果 在应用信息化医院感染管理体系前医院感染病例漏报率、多重耐药菌防控措施落实率、医院感染知识培训参学率分别为19.0%、78.2%、79.2%,应用后分别为0.0%、96.3%、97.1%;重症医学科(ICU)呼吸机相关性肺炎(VAP)率、导管相关性血流感染(CLABSI)率、导尿管相关泌尿系感染率(CAUTI)应用前分别为14.52‰、3.91‰、6.90‰,应用后分别为4.51‰、1.96‰、2.79‰,但2018年上半年CAUTI感染率仍高于全国41所医院35个综合ICU留置中心静脉导管的患者进行的监测结果(2.81‰),还需重点加强CAUTI干预措施的制定;医院感染督查、传染病监管、消毒灭菌效果监测结果的时效性明显提高。 结论 应用信息化手段建立科学化的医院感染管理机制,可有效提高医院感染管理质量与效率。 

Building a reasonable and efficient hospital infection management mechanism relying on informatization

Objective To explore a scientific, objective, and efficient hospital infection management mechanism. Methods Based on the blue dragonfly nosocomial infection management system, LIS, HIS, PACS, EMR, PDA, and OA system, a reasonable and efficient hospital infection management system of monitoring, quality control, evaluation and feedback was developed. The false negative rates, implementation rate of multi resistant bacteria prevention and control measures, hospital infection knowledge training participations rates, incidence of equipment related hospital infection, supervision of hospital infection, supervision of infectious diseases, effectiveness of monitoring results of disinfection and sterilization effect were compared through the application of the information management system. Results After using information hospital infection management system,the false negative rates, implementation rate of multi resistant bacteria prevention and control measures, hospital infection knowledge training participations rates were reduced to 0.0%, 96.3%, and 97.1% from 19.0%, 78.2%, and 79.2%. The infection rates of VAP, CLABSI, and CAUTI were reduced to 4.51‰, 1.96‰ and 2.79‰ from 14.52‰, 3.91‰ and 6.90‰. But the incidence of CLABSI was relatively high as compared with the class 35 hospital ICU of china, thus it should put emphasis on the constitution of the CLABSI interventions. The supervision of hospital infection, supervision of infectious diseases, effectiveness of monitoring results of disinfection and sterilization effect increased significantly. Conclusion The application of hospital infection management mechanism relying on the informatization can effectively improve the whole quality of hospital infection management and management efficiency.