Quality control of intensive care unit in Anhui province from 2013 to 2015: a cross-sectional survey_Chinese Journal of Evidence-Based Medicine

Authors：

PAN Xiaodong ¹ ,  LIU Bao ² , ZHOU Shusheng ² , LUO Xiaoming ³ , SUN Yun ⁴ , LU Weihua ⁵ , FANG Changtai ⁶ , WANG Huaxue ⁷

1. The Affiliated Medical College, Anhui Medical University, Hefei, 230001, P.R.China;
2. Intensive Care Unit, Anhui Provincial Hospital, Hefei, 230001, P.R.China;
3. Intensive Care Unit, The First Affiliated Hospital of Anhui Medical University, Hefei, 230001, P.R.China;
4. Intensive Care Unit, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230001, P.R.China;
5. Intensive Care Unit, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241101, P.R.China;
6. Intensive Care Unit, Anqing Municipal Hospital, Anqing, 246001, P.R.China;
7. Intensive Care Unit, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233001, P.R.China;

Corresponding author：

LIU Bao, Email: linux306@126.com

Keywords：

Anhui province; Intensive care unit; Quality control; Baseline survey

DOI：

10.7507/1672-2531.201705015

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ObjectiveTo investigate the baseline of quality control system for intensive care unit (ICU), and to provide a scientific basis for the development of ICU in Anhui province.MethodsA questionnaire was used to investigate the quality control indexes in 108 hospitals in Anhui province from 2013 to 2015. SPSS 20.0 statistical software was used to analyze and statistically describe the survey results.ResultsA total of 110 questionnaires from 108 hospitals were received, including 43 tertiary hospitals and 65 secondary hospitals. In these 110 ICUs, 96.36% were integrated ICU. The total average number of ICU beds was 14.46±7.12, accounting for 1.58%±1.04% of the total hospital beds. The ratios of practicing physicians-beds and registered nurses-beds were 0.57±0.24: 1 and 1.54±0.79: 1, respectively. A total of 29 hospitals (26.36%) met the conditions that the ratio of the total number of beds in the ICU to the hospital was 2% to 8%. Only 5 ICU (4.55%) could meet the conditions that each bed covered an area ≥15 m². The average incidence of ventilator-associated pneumonia, catheter-related blood stream infection and catheter-related urinary tract infection in ICU patients were (17.30±15.36) ‰, (3.07±3.93) ‰, and (3.49±4.27) ‰, respectively. The incidences in the tertiary hospitals were higher than the secondary hospital. There was no ICU to achieve all 19 key technologies. 42.73% directors of ICU engaged in the professional career more than 10 years. Only 2.73% of the medical institutions in the intensive medical staff performance distribution than the average level of hospital.ConclusionICU in Anhui province has been achieved a rapid development, and has covered all municipal hospitals and more than 80% of the county-level hospitals. But it confronts with a series of problems, such as lack of medical resources, the construction of talent echelon lag, low overall level of discipline, lack of specialist, work intensity, low performance and a series of constraints which restricted the development of disciplines. It strongly suggests that we should further improve the quality control system of critical care medicine, standardize the quality control process, improve and implement the standardized operation standard of critical care medicine, strengthen the construction of disciplines talent echelon. We are expected to enhance the overall level of discipline and to ensure medical quality and safety.

Citation： PAN Xiaodong, LIU Bao, ZHOU Shusheng, LUO Xiaoming, SUN Yun, LU Weihua, FANG Changtai, WANG Huaxue. Quality control of intensive care unit in Anhui province from 2013 to 2015: a cross-sectional survey. Chinese Journal of Evidence-Based Medicine, 2018, 18(4): 298-305. doi: 10.7507/1672-2531.201705015 Copy

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4.	van der Voort PH, vail der Veer SN, de Vos ML. The Use of indicators to improve the quality of intensive care. Acta Anaesthesiol Scand, 2012, 56(9): 1084-1091.
5.	Rhodes A, Moreno RP, Azoulay E, et al. Prospectively defined indicators to improve the safety and quality of care for critically ill patients: a report from the Task Force on Safety and Quality of the European Society of Intensive Care Medicine (ESICM). Intensive Care Med, 2012, 38(4): 598-605.
6.	沈伟锋, 干建新, 江观玉. 以" 三环理论”为指导, 建设我国急诊医疗服务体系. 中华医院管理杂志, 2004, 20(10): 595-597.
7.	王春亭, 陈曼, 于凯江, 等. 重症医学: 华东地区现状调查 (2015 年第三次 ICU 普查). 中华重症医学电子杂志, 2016, 2(1): 43-49.
8.	李国民. 江苏省 ICU 现况调查分析. 中华急诊医学杂志, 2006, 15(12): 1071-1074.
9.	张宇鸣, 樊寻梅. 我国 17 省儿科 ICU 调查. 中华急诊医学杂志, 2003, 12(5): 352-354.
10.	孙亚萍. 我院 ICU 质量控制现状分析. 中国现代医药杂志, 2015, 17(1): 37-40.
11.	周翔, 刘大为. 北京地区重症医学科质量控制现状调查的流行病学研究. 中国医刊, 2013, 48(12): 31-33.
12.	徐方林, 邹颋, 李峰, 等. 重症监护病房中心静脉导管相关性感染集束化预防措施的临床意义. 中国危重病急救医学, 2010, 22(9): 559-560.
13.	Ceballos K, Waterman K, Hulett T, et al. Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU. Adv Neonatal Care, 2013, 13(3): 154-163.

1. 中华医学会重症医学分会. 中国重症加强治疗病房 (ICU) 建设与管理指南. 中国危重病急救医学, 2006, 18(7): 387-388.
2. Donabedian A. The quality of care. How can it be assessed? JAMA, 1998, 260(12): 1743-1748.
3. 周翔, 马旭东, 刘大为. 新形势下重症医学质量控制要点. 中华医学杂志, 2014, 94(27): 2086-2089.
4. van der Voort PH, vail der Veer SN, de Vos ML. The Use of indicators to improve the quality of intensive care. Acta Anaesthesiol Scand, 2012, 56(9): 1084-1091.
5. Rhodes A, Moreno RP, Azoulay E, et al. Prospectively defined indicators to improve the safety and quality of care for critically ill patients: a report from the Task Force on Safety and Quality of the European Society of Intensive Care Medicine (ESICM). Intensive Care Med, 2012, 38(4): 598-605.
6. 沈伟锋, 干建新, 江观玉. 以" 三环理论”为指导, 建设我国急诊医疗服务体系. 中华医院管理杂志, 2004, 20(10): 595-597.
7. 王春亭, 陈曼, 于凯江, 等. 重症医学: 华东地区现状调查 (2015 年第三次 ICU 普查). 中华重症医学电子杂志, 2016, 2(1): 43-49.
8. 李国民. 江苏省 ICU 现况调查分析. 中华急诊医学杂志, 2006, 15(12): 1071-1074.
9. 张宇鸣, 樊寻梅. 我国 17 省儿科 ICU 调查. 中华急诊医学杂志, 2003, 12(5): 352-354.
10. 孙亚萍. 我院 ICU 质量控制现状分析. 中国现代医药杂志, 2015, 17(1): 37-40.
11. 周翔, 刘大为. 北京地区重症医学科质量控制现状调查的流行病学研究. 中国医刊, 2013, 48(12): 31-33.
12. 徐方林, 邹颋, 李峰, 等. 重症监护病房中心静脉导管相关性感染集束化预防措施的临床意义. 中国危重病急救医学, 2010, 22(9): 559-560.
13. Ceballos K, Waterman K, Hulett T, et al. Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU. Adv Neonatal Care, 2013, 13(3): 154-163.

Chinese Journal of Evidence-Based Medicine

Quality control of intensive care unit in Anhui province from 2013 to 2015: a cross-sectional survey

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