全国妇幼保健机构医院感染监测与防控实施现状调查报告
作者:
作者单位:

1.北京大学第一医院感染管理-疾病预防控制处, 北京 100034;2.山东第一医科大学附属省立医院医院感染管理办公室, 山东 济南 250021;3.中南大学湘雅医院医院感染控制中心, 湖南 长沙 410008;4.南方医科大学南方医院医院感染管理科, 广东 广州 510515;5.昆明医科大学第二附属医院医院感染管理办公室, 云南 昆明 650033;6.内蒙古医科大学附属医院医院感染管理与疾病预防控制部, 内蒙古 呼和浩特 010000;7.江苏省妇幼保健院感染管理处, 江苏 南京 210036;8.中国医科大学附属第一医院院内感染管理办公室, 辽宁 沈阳 110002;9.河北医科大学第四医院感染管理科, 河北 石家庄 050011;10.烟台市奇山医院院感管理科, 山东 烟台 264001

作者简介:

通讯作者:

李六亿  E-mail: lucyliuyi@263.net

中图分类号:

R197.323.4

基金项目:

国家卫生健康委妇幼健康司委托项目(2022年)


Implementation of surveillance, prevention and control of healthcare-associated infection in maternal and child healthcare institutions: A nationwide investigation report
Author:
Affiliation:

1.Department of Infection Management-Disease Prevention and Control, Peking University First Hospital, Beijing 100034, China;2.Office of Healthcare-associated Infection Management, Shandong Provincial Hospital, Shandong First Medical University, Jinan 250021, China;3.Center for Healthcare-associated Infection Control, Xiangya Hospital, Central South University, Changsha 410008, China;4.Department of Healthcare-associated Infection Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;5.Office of Healthcare-associated Infection Management, The Second Affiliated Hospital of Kunming Medical University, Kunming 650033, China;6.Department of Healthcare-associated Infection Management-Disease Prevention and Control, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010000, China;7.Department of Infection Management, Jiangsu Women and Children Health Hospital, Nanjing 210036, China;8.Office of Healthcare-associated Infection Management, The First Hospital of China Medical University, Shenyang 110002, China;9.Department of Infection Management, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China;10.Department of Healthcare-associated Infection Management, Yantai Qishan Hospital, Yantai 264001, China

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    摘要:

    目的 了解全国各级妇幼保健机构医院感染监测和防控措施的实施现状,为优化妇幼保健机构医院感染防控工作提供政策依据。 方法 从8个省/自治区的省部级、地市级和区县级妇幼保健机构中分层抽样,设计统一的调查问卷,以"问卷星"的形式开展线上调查。 结果 123所妇幼保健机构的数据纳入统计分析。90.24%的妇幼保健机构开展了医院感染综合性监测,开展新生儿监护室医院感染目标性监测、手术部位感染目标性监测、多重耐药菌目标性监测和重症监护病房(非新生儿)医院感染目标性监测的妇幼保健机构比率分别为89.66%、85.96%、80.77%和74.19%,51.22%的妇幼保健机构实现了医院感染病例信息化监测。94.31%的妇幼保健机构开展了手卫生依从性监测工作,90%以上的妇幼保健机构中医院感染高风险部门开展了环境卫生学监测,71.54%的妇幼保健机构由消毒供应中心对复用诊疗器械集中清洗、消毒、灭菌和供应。>90%的妇幼保健机构建立了三级预检分诊制度,86.18%的妇幼保健机构设置了过渡病房。妇幼保健机构对建档孕产妇、高危新生儿、保健人群和长期康复患者等特殊就诊人群普遍采取了建立有效沟通机制、全预约就诊和单独分区就诊的管理模式,但开展互联网复诊的妇幼保健机构比率 < 50%。 结论 妇幼保健机构普遍开展了医院感染综合性监测和目标性监测,信息化监测程度有待提高。手卫生和环境卫生学监测在各级妇幼保健机构中普及程度较高,少数妇幼保健机构复用诊疗器械清洗、消毒、灭菌和供应流程不规范。特殊就诊人群得到有效管理,互联网医疗有待进一步推广。

    Abstract:

    Objective To investigate the implementation of surveillance, prevention and control measures for healthcare-associated infection (HAI) in maternal and child healthcare (MCH) institutions, and provide policy evidence for optimizing HAI prevention and control in MCH institutions. Methods Stratified sampling was conducted among the MCH institutions at provincial, municipal and county levels in 8 provinces/autonomous regions. A unified questionnaire was designed and the online survey was conducted through "Questionnaire Star". Results The data from 123 MCH institutions were included in the analysis. 90.24% of the MCH institutions carried out comprehensive surveillance on HAI. The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit (NICU), surgical site infection, multidrug-resistant organisms (MDROs) and HAI in intensive care units (non-NICU excluded) were 89.66%, 85.96%, 80.77%, and 74.19%, respectively. 51.22% MCH institutions adopted information surveillance system on HAI cases. 94.31% MCH institutions carried out surveillance on hand hygiene compliance. Over 90% MCH institutions carried out surveillance on environment hygiene in high-risk departments. 71.54% MCH institutions conducted centralized cleaning, disinfection, sterilization and supply for reusable medical instruments in the central sterile supply department (CSSD). Over 90% MCH institutions established three-level pre-examination triage systems. 86.18% set up transitional wards. MCH institutions generally adopted a management model with established effective communication, full appointment visits, and separate visits for special medical groups, such as registered pregnant women, high-risk newborns, healthcare groups, and long-term rehabilitation patients. However, the ratio of institutions conducting on-line follow-up visits was less than 50%. Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI. Information surveillance need to be facilitated. Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions. The cleaning, disinfection, sterilization, and supply processes of reusable medical devices in a few MCH institutions are not standardized. Special medical populations get effective management. On-line healthcare is to be further promoted.

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李硕,姚希,贾会学,等.全国妇幼保健机构医院感染监测与防控实施现状调查报告[J]. 中国感染控制杂志,2024,23(3):323-329. DOI:10.12138/j. issn.1671-9638.20243823.
Shuo LI, Xi YAO, Hui-xue JIA, et al. Implementation of surveillance, prevention and control of healthcare-associated infection in maternal and child healthcare institutions: A nationwide investigation report[J]. Chin J Infect Control, 2024,23(3):323-329. DOI:10.12138/j. issn.1671-9638.20243823.

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  • 收稿日期:2023-08-22
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  • 在线发布日期: 2024-04-28
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