ObjectivesTo understand the current situation of the nosocomial infection management system in maternal and child health care institutions at all levels in Sichuan province, and provide a feasible policy basis for strengthening the nosocomial infection management.MethodsThe expert group members of Sichuan Maternal and Child Health Association Academy Association designed a unified questionnaire, and distributed the questionnaire through “Questionnaire Star” to carry out on-site online survey.ResultsA total of 159 maternal and child health care institutions participated in the survey. Most secondary and below maternal and child health care institutions had not set up professional hospital infection monitoring system. A few secondary and below maternal and child health care institutions did not independently set up a hospital infection management committee, hospital infection management department, full-time hospital infection department head, the inspection team of infection control, monitoring system, and nosocomial infection management system and special supervision had not been established in special departments. There were statistical differences in some jobs in the construction of nosocomial infection management system in different levels of maternal and child health care institutions (P<0.05).ConclusionsThe organizational system construction of hospital infection managemen are at a low level in the second level and below maternal and child health care institutions in Sichuan province. The tertiary maternal and child health care institutions should give full play to the leading role in promoting the standard construction of nosocomial infection management system of maternal and child health care institutions in Sichuan province, and carry out nosocomial infection management of maternal and child health care institutions orderly.
ObjectiveTo understand the current situation of hospital infection management related to the hospital maternity ward, learn the risks of infection, discover problems existing in hospital infection management, and seek appropriate solutions for hospital infection. MethodsBetween January 2011 and December 2012, using uniform questionnaire for prospective survey and field interviews, we investigated the hospital infection situation in medical health care workers, pregnant women, and live newborns. ResultsA total of 2 225 questionnaires were retreated with a retreat rate of 100%. Hospital infection occurred in 23 cases, of which 15 cases were maternal infection (1.35%) and 8 cases were neonate infection (0.72%). Maternal infection was mainly focused on reproductive tract, surgery incision and urinary tract. Neonate infection was mainly focused on lower respiratory tract and skin. The management system of hospital infection in the maternity ward was basically strengthened, but the infection monitoring work was still not timely, and staff training in infection control knowledge was not in place. The overall environment, sterilization, disinfection and isolation should be strengthened, and there were also some other safety hazards. ConclusionThe management of infection in hospital maternity ward is the key to control the infection in maternity ward. The infection management seems perfect, but there are still some hidden dangers. The management system needs to be improved and the management should be implemented strictly according to the system, in order to avoid the occurrence of infection in maternity ward and ensure the safety of patients.
Objective To investigate and analyze the difficulties of nosocomial infection management in different-level medical institutions in Shanghai, and to provide scientific basis for improving the level of nosocomial infection management. Methods A questionnaire was designed to include 10 difficulties in nosocomial infection management such as professional title promotion, salary, and personnel allocation. In October 2023, the Shanghai Nosocomial Infection Quality Control Center, in collaboration with the Shanghai Hospital Association, conducted a questionnaire survey among the heads of nosocomial infection management departments in medical institutions in Shanghai. The scores of difficulties were analyzed by stratification according to hospital level, allocation and changes of full-time personnel. Results A total of 548 questionnaires were distributed, and 530 valid questionnaires were retrieved, with a recovery rate of 96.72%. There were 55 public tertiary, 93 public secondary, 169 public primary and 213 social medical institutions. The rates of full-time personnel allocation meeting standards were 76.36% (42/55), 72.04% (67/93), 31.95% (54/169), and 21.60% (46/213), respectively. There was a statistically significant difference in the rates of full-time personnel allocation meeting standards among different levels of medical institutions (χ2=105.149, P<0.001). There was no statistical difference in the total scores of nosocomial infection management difficulties among different-level medical institutions (F=1.657, P=0.176). There were statistically significant differences in the scores of difficulties in professional title promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel, and high personnel turnover (P<0.05). Conclusions The main difficulties in nosocomial management of medical institutions at all levels in Shanghai include the difficulty in career promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel and lack of experience. In the future, medical institutions should strengthen the allocation of full-time personnel and enhance their capabilities, provide smooth promotion channels, to promote the high-quality development of nosocomial infection management ultimately.
Objective To explore the effect of “net bottom” management in the control of device-associated infections (DAIs) in elderly patients by setting infection monitoring doctors and nurses in the emergency intensive care unit (EICU). Methods Elderly patients who aged≥60 years old admitted to the EICU of the First People’s Hospital of Lianyungang between April 2018 and March 2021 were selected as the research subjects. A “net bottom” management mode was established and implemented for the purpose of infection prevention and control, taking medical and other departments as the coordination and management subjects, and infection monitoring doctors and nurses as the core. The effectiveness of the management intervention was evaluated by comparing the incidences of DAIs in elderly patients, the compliance rates of medical staff in hand hygiene, and the consumption of hand sanitizer per bed day in EICU among the primary stage (from April 2018 to March 2019), intermediate stage (from April 2019 to March 2020), and later stage (from April 2020 to March 2021). Results During the primary stage, intermediate stage, and later stage, there were 540, 497, and 507 elderly inpatients in EICU monitored, respectively, and the incidences of nosocomial infections were 7.22% (39/540), 5.84% (29/497), and 4.14% (21/507), respectively, showing a decreasing trend (χ2trend=4.557, P=0.033). The incidences of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections decreased from 4.82‰, 2.53‰, and 0.95‰, respectively in the primary stage, to 0.51‰, 1.01‰, and 0.53‰, respectively in the later stage, among which the difference in the incidence of ventilator-associated pneumonia was statistically significant (P<0.05). The hand hygiene compliance rate of EICU medical staff increased from 70.39% to 86.67% (P<0.05), and the consumption of hand sanitizer per bed day increased from 33.70 mL to 67.27 mL. The quarterly hand hygiene compliance rate was positively correlated with the quarterly consumption of hand sanitizer per bed day (rs=0.846, P=0.001), and negatively correlated with the quarterly incidence of nosocomial infections (rs=–0.769, P=0.003). Conclusion The “net bottom” management by setting up infection monitoring doctors and nurses in the EICU and multi-department collaboration can reduce the incidence of DAIs in elderly patients in EICU, which plays a positive role in promoting the hospital infection management and improving the quality of hospital infection management.
目的:通過對可重復使用物（管道類）存放現狀的調查，為基層醫院感染管理提供一定的理論依據。方法:對本市10家二級及以上醫療機構40個臨床科室可重復使用醫療用物（管道類）的管理情況進行問卷調查，2007年2月對可重復使用醫療用物進行微生物監測。結果:共334件管道，其中二級醫院218件，菌落超標34件，占10.17%；三級醫院116件，菌落超標7件，占2.09%。結論:建立對可重復使用醫療用物管理制度，規范操作規程，才能有效防止醫院感染。
During the medical rescue after the Wenchuan earthquake, in order to prevent hospital environmental pollution and cross infection, the nosocomial infection control committee of West China Hospital of Sichuan University immediately initiated the emergency response plan, improved the triage system, and organized multi-disciplinary infection control groups to improve the triage of the wounded and the infection control of the emergency department. At the same time, we regulated the individual behavior of healthcare professionals and took appropriate measures for personnel protection so as to ensure the safety of both the wounded and healthcare professionals.
Objective To understand the current status of nosocomial infection management in secondary and higher medical institutions in the city to find out the problems and put forward countermeasures. Methods According to the standard of " 19. Nosocomia Infection Management” in the evaluation standard of Sichuan Provincial General Hospital of 2011, the nosocomial infection management of 18 hospitals at or above grade 2 was supervised and evaluated on site. Results The average score of the 18 hospitals was 84.88±2.58. Organization and management had the highest pass rate (83.33%), while the catheter room had the lowest (33.33%). Concusion The 18 hospitals’ nosocomial infection management has been led to different degrees of attention, to build a hospital management organizational structure, developed a more comprehensive rules and regulations and work processes. But in key sectors and key links, the pass rate is still low, it needs to timely update the management concept, increase the necessary facilities and equipment for sensing and controlling, refine the control measures, formulate the pre-plan process and quality assessment standards and effectively implement.
ObjectiveTo enhance the management of occupational exposure, improve post-exposure reporting, promote post-exposure follow-up, reduce blood-borne infections caused by exposure, and ensure occupational safety among medical staff by using comprehensive measures based on nosocomial infection management system.MethodsAll the reported cases of occupational exposure were retrospectively collected from August 2012 to July 2018. The cases were divided into the control group (from August 2012 to July 2015) in which the data were reported in paper, and the observation group (from August 2015 to July 2018) in which the data were reported by nosocomial infection management system. The report and follow up results of occupational exposure in the two groups were compared and analyzed.ResultsAfter three years application of nosocomial infection management system, the occupational exposure report increased 95.8% (increased from 16.7 cases per year to 32.7 cases per year); the follow-up ratio of occupational exposure after one month,3 months and 6 months increased from 65.0% to 93.3% (χ2=15.184, P<0.001), 45.0% to 73.3% (χ2=9.033, P=0.003), and 25.0% to 53.3% (χ2=8.522, P=0.004), respectively.ConclusionApplication of nosocomial infection management system can increase the report of occupational exposure and the follow-up ratio of occupational exposure significantly.
Objective To evaluate the effect of ECRS management model on the quality of prevention and control of hospital infection with multidrug-resistant organisms (MDROs). Methods The data related to the prevention and control of MDROs in the First Hospital of Nanchang in 2020 and 2021 were retrospectively collected. The hospital implemented routine MDRO infection prevention and control management in accordance with the Expert Consensus on the Prevention and Control of Multi-drug Resistant Bacteria Nosocomial Infection in 2020. On this basis, the hospital applied the four principles of the ECRS method to cancel, combine, rearrange and simplify the MDRO infection prevention and control management. The detection rate of MDROs on object surfaces, the incidence rate of hospital infection of MDROs, the compliance rate of hand hygiene, the implementation rate of contact isolation prevention and control measures, and the pass rate of MDRO infection prevention and control education assessment were analyzed and compared between the two years. Results The detection rate of MDROs on the surfaces in 2021 was lower than that in 2020 (9.39% vs. 31.63%). The hospital-acquired MDRO infection rate in 2021 was lower than that in 2020 (1.18% vs. 1.46%). The hand hygiene compliance rates of medical staff, workers and caregivers in 2021 were higher than those in 2020 (90.99% vs. 78.63%, 73.51% vs. 45.96%, 70.96% vs. 33.71%). The implementation rate of contact isolation prevention and control measures in 2021 was higher than that in 2020 (93.31% vs. 70.79%). The qualified rates of MDRO infection prevention and control education in medical personnel, workers and caregivers in 2021 were higher than those in 2020 (96.57% vs. 81.31%, 76.47% vs. 47.95%, 73.17% vs. 34.19%). All the differences above were statistically significant (P<0.05). Conclusion ECRS management mode can improve the execution and prevention level of MDRO hospital infection prevention and control, and reduce the incidence of MDRO hospital infection.