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目的探讨能力素质冰山模型对儿科住院患者医院感染的预防控制效果,为降低医院感染提供新的途径。方法选取2013年7月-2016年6月在医院儿科住院患儿2586例,分为对照组和研究组;2013年7月-2014年12月期间接受常规干预的患者1315例为对照组,2015年1月-2016年6月接受能力素质冰山模型干预的患者1271例为研究组,比较两组患者的感染率与两组工作人员的手卫生依从性情况及对医院感染预防的相关知识掌握情况,比较两组患者的住院时间和满意度,并统计两组患者感染后病原菌分布。结果研究组和对照组患者的感染率分别为1.4%、5.5%,研究组患者感染率低于对照组,差异有统计学意义(P<0.05);对照组感染患者72例,其中单一感染患者64例,混合感染患者8例,共分离出病原菌80株,以革兰阴性菌为主占53.8%,革兰阳性菌占40.0%,真菌占6.3%;研究组感染患者18例,其中单一感染患者15例,混合感染患者3例,共分离培养病原菌21株,以革兰阴性菌为主占52.4%,革兰阳性菌占38.1%,真菌占9.5%;研究组工作人员对手卫生时机、六步洗手法、手卫生必要性、消毒液的应用、擦拭规范、污染物处理的知识评分均显著高于对照组,差异有统计学意义(P<0.05)。结论将能力素质冰山模型应用于儿科住院患者医院感染的预防控制措施中可以有效降低医院感染率,提升工作人员手卫生依从性、预防感染相关知识掌握程度,能缩短住院时间、提升患者满意度,值得临床推广。
Objective To explore the preventive and control effects of the competency iceberg model on nosocomial infection in pediatric inpatients and to provide a new way to reduce nosocomial infection. Methods From July 2013 to June 2016, 2586 children hospitalized in the pediatric department of pediatrics were divided into control group and study group; 1315 patients who received routine intervention from July 2013 to December 2014 were the control group, 2015 January 2007 - June 2016 1271 patients accepted the ability and quality of the iceberg model intervention group for the study group, comparing the infection rate of two groups of patients with two groups of staff hand hygiene compliance and knowledge of hospital infection prevention knowledge The hospitalization time and satisfaction of the two groups were compared, and the distribution of pathogenic bacteria in the two groups was also calculated. Results The infection rates in study group and control group were 1.4% and 5.5%, respectively. The infection rate in study group was lower than that in control group (P <0.05). In control group, 72 cases were infected with single infection 64 cases, mixed infection in 8 cases, a total of 80 pathogens were isolated, with Gram-negative bacteria accounted for 53.8%, Gram-positive bacteria accounted for 40.0%, fungi accounted for 6.3%; study group infected 18 patients, including a single infection There were 15 cases of patients and 3 cases of mixed infection. 21 strains of pathogens were isolated and cultured, of which, Gram-negative bacteria accounted for 52.4%, Gram-positive bacteria accounted for 38.1% and fungi accounted for 9.5%. In the research group, The methods of hand washing, the necessity of hand hygiene, the application of disinfectant, wiping standard and the knowledge score of pollutant treatment were all significantly higher than those of the control group (P <0.05). Conclusion The application of competency iceberg model to prevention and control of nosocomial infections in pediatric inpatients can effectively reduce the rate of nosocomial infection, improve hand hygiene compliance of staff, prevent mastery of knowledge related to infection, shorten hospital stay and improve patient satisfaction, Worth clinical promotion.