ObjectiveTo analyze the risk factors for hospital infection in the medical physical examination center of a newly opened hospital, and to explore its prevention and control measures. MethodsBetween April and December 2012, we analyzed the risk factors for hospital infection in the physical examination center of a new hospital. A series of hospital infection prevention and control measures such as carrying out education and training of medical personnel, strengthening the prevention of needle stick injuries, implementing strict disinfection and sterilization, improving environmental hygiene, and implementing medical waste management, were developed. ResultsMedical staff's knowledge of disinfection and sterilization was improved; hand hygiene compliance was increased; hospital environmental hygiene was promoted, and medical waste was properly sorted out. ConclusionTaking reasonable measures for infection prevention and control can increase medical staff's awareness of hospital infection prevention and control, improve their practices of infection control and prevent hospital infections from occurring eventually.
In recent years, with the increasing attention of health administrative departments and medical institutions at all levels to hospital infection, the prevention and control of hospital infection is increasing. As an important part of the quality control network, the role of provincial quality control center has a very important impact on the effectiveness of quality control work. Since its establishment, “Gansu Provincial Medical Quality Control Center of Hospital Infection Management” has actively explored the quality control mode suitable for the provincial situation, continuously strengthened the basic hospital infection quality control work, and innovated the quality control forms, especially the special quality control activities of “Infection Prevention in Gansu Province” with the core content of “supervision, training and investigation” carried out in combination with the provincial situation, which has created a new quality control work mode of the provincial quality control center. It is recognized and promoted by the national counterparts, and playes a positive role in promoting the management of hospital infection in the whole province. This article expounds the supervision practice of “Infection Prevention in Gansu Province” from four aspects in detail.
ObjectiveTo study the present situation of hospital orthopedic surgery incision infection, in order to provide the basis for further intervention. MethodsProspective investigation combined with retrospective investigation method was adopted in our study to perform a statistical analysis on orthopedic surgery incision infections among 545 patients in our hospital between January and December 2012. ResultsDuring the one year of follow-up, there were 10 cases of surgical incision infection among all the 545 patients, with an infection rate of 1.83%. The infection rate of class-Ⅰ incision was 0.46%, of class-Ⅱ was 5.13%, and of class-Ⅲ/Ⅳ was 12.12%, and the Cochrane-Armitage trend chi-square test showed significant trend among them (χ2=28.273, P<0.001). Based on different operation risk index, patients with index 1, 2, 3 had a surgical site infection rate of 0.82%, 2.60%, and 18.75%, respectively. The higher the index, the higher the surgery incision infection rate, and the trend was statistically significant (χ2=12.916, P<0.001). The infection rate was 1.43% for elective surgical procedures, and was 3.15% for emergency surgery, but there was no significant difference (P>0.05). ConclusionOrthopedic surgery has a high-risk surgical site infection rate, and incision classification and surgical risk index have statistical correlation with the incidence of hospital infection. In order to ensure the security of patients and reduce medical disputes, we should pay close attention to orthopedic surgery infection.
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.
The prevention and control of COVID-19 has entered a critical moment. “Disease control of 2019 novel coronavirus infection in hospital: West China urgent recommendation” based on the best available evidence and expert experience, provided emergency recommendations for key clinical issues in hospital prevention and control during the COVID-19 epidemic. This recommendation with strong reference value and timeliness is worth learning for hospital managers, sensory control personnel and medical staff at all levels. All medical institutions should establish an emergency response mechanism to accelerate the formation of medical teams and strengthen the protection of medical staff and hospital infection control. We should enhance the implementation of policy and reinforce risk assessment. It is essential to strengthen the implementation of various prevention and control measures as well as risk assessment so as to eventually win the battle of coronavirus infection as soon as possible.
ObjectiveTo investigate the incidence of nosocomial infection and device-related infection in the Intensive Care Unit (ICU), analyze its related risk factors, and search for effective measures to prevent and control nosocomial infection. MethodsBy prospective objective monitoring method, we surveyed 294 patients hospitalized in the ICU for at least 48 hours between January and December 2012. The doctor in charge filled in relevant information of the patients to complete the questionnaires, and hospital infection management staff was responsible for tracking, judging, and statistical analysis. ResultsIn the 294 patients, 61 had hospital infections, and there were 78 cases. The hospital infection rate was 20.75%, and the case infection rate was 26.53%. The day incidence of patient infection was 16.01‰, and day infection rate was 20.47‰ for infection cases. After average severity of illness score adjustment, the day case infection rate was 7.48%, ventilator associated pneumonia (VAP) infection rate was 27.27‰, central venous catheter associated bloodstream infection rate was 6.58‰, and catheter associated urinary tract infection rate was 3.15‰. ConclusionICU has a high risk of hospital infection. In the device related infections, VAP infection rate is the highest. Continuous improvement can be achieved through monitoring and discovering problems, strengthening hospital infection management training for the medical personnel of the hospital, close communication between doctors and hospital infection management staff, and strict implementation of hospital infection management measures.
ObjectiveTo analyze and discuss the importance of non-catheter-related hospital infection in intensive care unit (ICU). MethodA prospective target monitoring of all the patients in the general ICU was carried out from January 2011 to December 2013. The hospital infection cases grouped by infection types were analyzed with SPSS 17.0. ResultsA total of 5 364 patients were monitored, 455 of whom had hospital infections totaled 616 times. The hospital infection rate was 11.5%. The amount and constituent ratio of the catheter-related infections showed a declining trend year by year, while the non-catheter-related infections revealed an escalating trend year by year. In these 455 patients, the mixed infection group had the longest hospital stay, followed by the catheter-related infection group and the non-catheter-related infection group (P<0.05). The catheter-related infection group had higher crude mortality rate than both of the mixed infection group and the non-catheter-related infection group (P<0.017). ConclusionsNon-catheter-related infections which get higher and higher proportion in ICU hospital infections should be paid more attention to, while catheter-related infections which could prolong hospitalization and increase the risk of death in ICU patients, remain the focus of the target monitoring of hospital infection in ICU.
Objective To explore the independent risk factors for hospital infections in tertiary hospitals in Gansu Province, and establish and validate a prediction model. Methods A total of 690 patients hospitalized with hospital infections in Gansu Provincial Hospital between January and December 2021 were selected as the infection group; matched with admission department and age at a 1∶1 ratio, 690 patients who were hospitalized during the same period without hospital infections were selected as the control group. The information including underlying diseases, endoscopic operations, blood transfusion and immunosuppressant use of the two groups were compared, the factors influencing hospital infections in hospitalized patients were analyzed through multiple logistic regression, and the logistic prediction model was established. Eighty percent of the data from Gansu Provincial Hospital were used as the training set of the model, and the remaining 20% were used as the test set for internal validation. Case data from other three hospitals in Gansu Province were used for external validation. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were used to evaluate the model effectiveness. Results Multiple logistic regression analysis showed that endoscopic therapeutic manipulation [odds ratio (OR)=3.360, 95% confidence interval (CI) (2.496, 4.523)], indwelling catheter [OR=3.100, 95%CI (2.352, 4.085)], organ transplantation/artifact implantation [OR=3.133, 95%CI (1.780, 5.516)], blood or blood product transfusions [OR=3.412, 95%CI (2.626, 4.434)], glucocorticoids [OR=2.253, 95%CI (1.608, 3.157)], the number of underlying diseases [OR=1.197, 95%CI (1.068, 1.342)], and the number of surgical procedures performed during hospitalization [OR=1.221, 95%CI (1.096, 1.361)] were risk factors for hospital infections. The regression equation of the prediction model was: logit(P)=–2.208+1.212×endoscopic therapeutic operations+1.131×indwelling urinary catheters+1.142×organ transplantation/artifact implantation+1.227×transfusion of blood or blood products+0.812×glucocorticosteroids+0.180×number of underlying diseases+0.200×number of surgical procedures performed during the hospitalization. The internal validation set model had a sensitivity of 72.857%, a specificity of 77.206%, an accuracy of 76.692%, and an AUC value of 0.817. The external validation model had a sensitivity of 63.705%, a specificity of 70.934%, an accuracy of 68.669%, and an AUC value of 0.726. Conclusions Endoscopic treatment operation, indwelling catheter, organ transplantation/artifact implantation, blood or blood product transfusion, glucocorticoid, number of underlying diseases, and number of surgical cases during hospitalization are influencing factors of hospital infections. The model can effectively predict the occurrence of hospital infections and guide the clinic to take preventive measures to reduce the occurrence of hospital infections.
ObjectiveTo investigate the prevalence of nosocomial infection in a hospital and to provide a basis for hospital infection control. MethodsUsing bedside investigation and medical records analysis, we surveyed all hospitalized patients from 00:00 to 24:00 on July 19th, 2013. ResultsThe real investigation was carried out on 1815 patients out of all the 1828 patients with a real investigation rate of 99.29%. There were 55 cases of nosocomial infection (55 case-times), and both the nosocomial point infection rate and case-time infection rate were 3.03%. The top three departments with the highest rate were Intensive Care Unit (37.50%), Neurosurgery Department One (13.73%) and Neurosurgery Department Two (12.00%). Most infections occurred on the lower respiratory tract, which accounted for 45.45%. Nosocomial infection pathogenic detection rate was 38.18% (21/55):6 cases of Staphylococcus aureus (28.57%), 5 of Pseudomonas aeruginosa (23.81%), 3 of Klebsiella pneumoniae (14.29%), and 2 cases of Acinetobacter baumanii (9.52%). The rate of antimicrobial drug use was 24.08%, in which drug treatment accounted for 75.29%. Gender, surgery, urinary catheter, vascular catheter, tracheostomy, ventilator application, hemodialysis, and use of antibiotics were all influencial factors for occurrence of nosocomial infection. ConclusionNosocomial infection prevalence survey can help fully understand the status of hospital infection, help to carry out targeted surveillance, and better guidance for hospital to prevent and control nosocomial infection.
ObjectiveTo investigate the effects of nursing interventions on reducing the hospital infection rates in children with extremely low birth weight. MethodsA total of 158 children with extremely low birth weight were treated in our hospital from January 2012 to June 2013. Based on the routine care, we took a series of other nursing interventions, such as strengthening environmental management, strict materials management and disinfection, active prevention of ventilator-associated pneumonia and catheter-related bloodstream infections, close monitoring of a series of isolated neonatal care interventions, to reduce the nosocomial infections in these children. ResultsThe hospital infection rate of this group of children was 9.49%, and the rate of infection cases was 10.76%. The infection sites included blood system, respiratory tract, digestive tract, mouth and eye. The patients were improved or cured after anti-infection and symptomatic treatment and caring measures. ConclusionScientific nursing interventions can reduce the incidence of nosocomial infection in children with extremely low birth weight.