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 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 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.
ObjectiveTo investigate the management of hospital infection control of 23 hospitals in Sichuan province, China for making the questionnaires and providing basic data of the China-U.S. cooperative program on emerging and re-emerging infectious diseases "The Nosocomial Infection Surveillance Project in China". MethodsWe selected 23 representative hospitals from different regions of Sichuan in the survey for the management of hospital infection control. The survey included basic situation of the hospital such as the hospital level, ownership, number of beds, employees and discharged patients, the situation of hospital infection management such as the organization of management, the previous surveillance for prevalence of nosocomial infection, the composition of the staff, and the distribution pattern of important pathogens. ResultsThere were 18 Triple A hospitals, 1 Double A hospital, 4 Triple B hospitals were investigated, of which there were21 general hospitals and 2 specialty hospitals. The total number of patient beds were 26 801. The total numbers of staff were 32 757 including 8 571 doctors, 13 611 nurses, 1 391 technicians and 1 014 pharmacists. In 2010, the total numbers of out-patients, operations, and discharged patients were 16 127 038, 334 057, and 776 806, and the length of mean hospital stays were 11.30 days. All hospitals established the hospital infection control department with 105 infection control professionals. Most of the staffs of infection control department had medical or nursing background with college, or undergraduate level. Nineteen hospitals (82.61%) did the surveillance for the prevalence of nosocomial infection. The last surveillance showed the mean rate of hospital infection was 2.58%. Lower respiratory tract, upper respiratory tract and surgical site infection were top three infections. The annual number of culture specimens totalled 267 061; the average positive rate was 33.06%. Escherichia coli, klebsiella pneumoniae, pseudomonasaeruginosa, staphylococcus aureus and acinetobacter baumannii were top five infectious bacteria. ConclusionThe survey on the hospital infection control management could help us understand the overall situation of the hospital infection control. Also it could found the weaknesses and targeted interventions for the future project, and ensure the authenticity and reliability of the data for this research project eventually.
Improving the quality of infection management in outpatient and emergency departments is crucial for ensuring medical safety and advancing infection control practices. To enhance the level of infection management in outpatient and emergency departments, Tengzhou Central People’s Hospital developed a two round risk assessment system for outpatient and emergency departments hospital infection management using risk matrix and failure mode and effects analysis methods, including hospital-outpatient and emergency departments, very high risk outpatient and emergency departments-high risk point. Based on the enterprise risk management integration framework, the risk management system has been optimized to provide decision support for the prevention and control of outpatient and emergency departments hospital infection. This article will introduce the practical exploration experience of optimizing management in outpatient and emergency departments hospital infection based on risk assessment.
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.
ObjectiveTo explore the variation tendency of hospital infection and the antibacterial usage between 2011 and 2012,analyze the factors for hospitalization infection,and instruct on taking effective intervention measures,in order to reduce the rate of hospital infection,and thus to provide a scientific basis for the prevention and control of hospital infection. MethodsAll patients hospitalized in our hospital from 00:00 to 24:00 between September 21,2011 and August 16,2012 were investigated.By using the method of combined clinical investigation and case study,we asked the patients to fill the case questionnaires standardly,and analyzed the hospital infection cases on the survey day. ResultsA total of 1165 hospitalized patients were investigated from the year 2011 to 2012,and the actual check rate was 100%.A total of 46 cases of hospital infection occurred in 39 patients.The prevalence rate of hospital infection was 3.88% in 2011 and 2.80% in 2012.High rate hospital infections occurred in the Department of Neurosurgery which was 27.27% and Cardiothoracic surgery which was 16.67% in 2011.In 2012,the departments included ICU which was 28.57% and Internal Cardiovascular Medicine which was 9.09%.The main infection sites were respiratory tract,followed by urinary tract and superficial incisions.The usage rates of antibiotics were 63.07% and 40.56% respectively in the two years.There were significant difference in antibiotic use rate between the two years (P<0.01). ConclusionThe focus of future work is to strengthen the management of respiratory tract,urinary tract and surgical site infections,and to use antimicrobial drugs reasonably,in order to reduce hospital infection effectively.
Running an infection control regular meeting is an effective way to develop and improve the communication between the infection control team and clinical units. This paper introduces the infection control regular monthly meeting which is held in the last week of each month in a newly-opened branch hospital of a university teaching hospital in China. Through collecting the issues for discussion beforehand, feeding back the surveillance data of last month including nosocomial infection, hand hygiene, multidrug-resistant organisms, occupational exposure, and medical waste, discussing the current infection control issues from each ward and trying to solve them together, and delivering and sharing new knowledge, skills, and information in terms of infection control, the monthly meeting achieves remarkable successes in the aspects of promoting the hospital infection control-related cultural construction, enhancing the supervision and implementation of infection control measures, and running new projects on hospital infection management, etc. Infection control regular monthly meeting builds up a study and work platform, promotes the multidisciplinary and multi-department communication and collaboration, and improves the quality of infection control eventually.