Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
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 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.
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 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.
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 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 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.
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.
Objective To investigate the pathogen distribution and drug resistance in ICU patients, provide reference for prevention of severe infection and empirical antibacterial treatment. Methods The patients admitted in ICU between January 2013 and December 2014 were retrospectively analyzed. The pathogenic data were collected including bacterial and fungal culture results, the flora distribution and drug resistance of pathogenic bacteria. Results A total of 2088 non-repeated strains were isolated, including 1403 (67.2%) strains of Gram-positive bacteria, 496 (23.8%) strains of Gram-negative bacteria, and 189 (9.0%) strains of fungus. There were 1324 (63.42%) strains isolated from sputum or other respiratory specimens, 487 (23.33%) strains from blood specimens, 277 (13.27%) strains from other specimens. The bacteria included Acinetobacter baumannii (17.2%), Klebsiella pneumoniae (14.8%), Pseudomonas aeruginosa (9.9%), C. albicans (6.3%), E. coli (5.6%), E. cloacae (5.4%), Epidermis staphylococcus (5.0%) and Staphylococcus aureus (4.7%). There were 15 strains of penicillium carbon resistant enterobacteriaceae bacteria (CRE) accounting for 2.3%, including 5 strains of Pneumonia klebsiella, 4 strains of E. cloacae. In 117 strains of E. coli, drug-resistant strains accounted for 86.4% including 85.5% of multiple drug-resistant strains (MDR) and 0.9% of extremely-drug resistant (XDR) strains. In 359 strains of Acinetobacter baumannii, drug-resistant strains accounted for 75.2% including 72.1% of XDR strains and 3.1% of MDR strains. MDR strains accounted for 10.6% in Pseudomonas aeruginosa. Detection rate of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase-negative Staphylococci (MRCNS) was 49.0% and 95.5%, respectively. There were 4 strains of vancomycin resistant Enterococcus faecalis. There were 131 (69.3%) strains of C. albicans, 23 (12.2%) strains of smooth candida. C. albicans was sensitive to amphotericin and 5-fluorine cytosine, and the resistance rate was less than 1% to other antifungle agents. The resistance rate of smooth ball candida was higher than C. albicans and nearly smooth candida, but still less than 15%. Conclusions The predominant pathogens in ICU was gram-negative bacteria. The top eight pathogenic bacteria were Acinetobacter baumanni, Klebsiella pneumoniae, Pseudomonas aeruginosa, C. albicans, E. coli, E. cloacae, Epidermis staphylococcus and S. aureus. Sputum and blood are common specimens. CRE accounts for 2.3%. Drug-resistant strains are most common in E. coli mainly by MDR, followed by Acinetobacter baumannii mainly by XDR, and least in Pseudomonas aeruginosa. C. albicans is the most common fungus with low drug resitance.