| 摘要: |
| 目的 构建基于多学科协作（MDT）的脑血管病内科ICU多重耐药菌（MDRO）感染预防控制管理方案，并评价其应用效果。方法 采用便利抽样法，将入住海军军医大学（第二军医大学）第一附属医院脑血管病内科ICU符合准入标准的161例脑血管疾病患者作为研究对象，其中2022年1月至6月入住的79例患者为对照组，2022年9月至2023年2月入住的82例患者为干预组。对照组患者进行常规感染控制管理，干预组采用基于MDT的脑血管病内科ICU MDRO感染预防控制管理方案。分析并比较两组患者MDRO感染发生率，以及患者隔离措施、隔离医嘱、隔离标识、消毒措施落实情况与医务人员手卫生落实、MDRO防控知识知晓情况等MDRO感染防控措施的依从率。结果 干预组患者的MDRO感染发生率由对照组的45.57%（36/79）下降至28.05%（23/82），患者隔离措施、隔离医嘱、隔离标识、消毒措施落实情况与医务人员手卫生落实、MDRO防控知识知晓情况的依从率分别由79.63%（86/108）、70.51%（55/78）、76.47%（78/102）、71.32%（97/136）、86.28%（283/328）、82.24%（125/152）上升至92.00%（69/75）、90.00%（63/70）、92.50%（74/80）、93.48%（86/92）、92.66%（265/286）、93.91%（108/115），差异均有统计学意义（P均＜0.05）。结论 基于MDT的脑血管病内科ICU MDRO感染预防控制管理方案可有效降低脑血管病内科ICU MDRO感染风险，提高医院MDRO感染防控措施的依从性。 |
| 关键词: 多学科协作 多重耐药菌 管理方案 感染控制 重症监护室 |
| DOI：10.16781/j.CN31-2187/R.20230245 |
| 投稿时间：2023-05-04修订日期：2023-10-10 |
| 基金项目:军队护理创新与培育专项计划(培育) (2021HL029). |
|
| Construction and application of multi-drug resistant organism infection control management program based on multidisciplinary team in cerebrovascular intensive care unit |
| YU Longjuan1△,ZHANG Tingting1△,CHEN Juan1,SHEN Hongping1,LI Chen1,XIE Shan1,CHEN Yi2* |
(1. Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To establish a multidisciplinary team (MDT)-based management program for the prevention and control of multi-drug resistant organism (MDRO) infection in cerebrovascular intensive care unit (ICU) and to evaluate its efficacy. Methods A total of 161 patients with cerebrovascular diseases, who met the admission criteria and were admitted to the ICU of Department of Cerebrovascular Medicine of The First Affiliated Hospital of Naval Medical University (Second Military Medical University), were enrolled using convenience sampling method. Among them, 79 patients (admitted from Jan. to Jun. 2022) were in control group and 82 patients (admitted from Sep. 2022 to Feb. 2023) were in intervention group. The control group received routine infection control management, while the intervention group received the MDRO infection prevention and control management program based on MDT in ICU of cerebrovascular medicine departments. The incidence of MDRO infection of the patients and the compliance rates of MDRO prevention and control measures (including the implementation of isolation measures, isolation medical orders, isolation identification and disinfection measures of the patients, and the hand hygiene implementation and awareness of MDRO prevention and control knowledge of medical staff) were analyzed and compared between the 2 groups. Results In the intervention group, the incidence of MDRO infection was significantly decreased from 45.57% (36/79) in the control group to 28.05% (23/82) (P＜0.05); the compliance rates of implementation of isolation measures, isolation medical orders, isolation identification and disinfection measures of the patients, and hand hygiene implementation and awareness of MDRO prevention and control knowledge of medical staff were significantly increased from 79.63% (86/108), 70.51% (55/78), 76.47% (78/102), 71.32% (97/136), 86.28% (283/328), and 82.24% (125/152) to 92.00% (69/75), 90.00% (63/70), 92.50% (74/80), 93.48% (86/92), 92.66% (265/286), and 93.91% (108/115), respectively (all P＜0.05). Conclusion MDT-based MDRO infection prevention and control management program can effectively reduce MDRO infection in ICU of cerebrovascular medicine departments and improve the compliance of MDRO nosocomial infection prevention and control. |
| Key words: multidisciplinary team multi-drug resistant organism management program infection control intensive care unit |
