Objective To understand the current status of nosocomial infection management in secondary and higher medical institutions in the city to find out the problems and put forward countermeasures. Methods According to the standard of " 19. Nosocomia Infection Management” in the evaluation standard of Sichuan Provincial General Hospital of 2011, the nosocomial infection management of 18 hospitals at or above grade 2 was supervised and evaluated on site. Results The average score of the 18 hospitals was 84.88±2.58. Organization and management had the highest pass rate (83.33%), while the catheter room had the lowest (33.33%). Concusion The 18 hospitals’ nosocomial infection management has been led to different degrees of attention, to build a hospital management organizational structure, developed a more comprehensive rules and regulations and work processes. But in key sectors and key links, the pass rate is still low, it needs to timely update the management concept, increase the necessary facilities and equipment for sensing and controlling, refine the control measures, formulate the pre-plan process and quality assessment standards and effectively implement.
ObjectiveTo enhance the management of occupational exposure, improve post-exposure reporting, promote post-exposure follow-up, reduce blood-borne infections caused by exposure, and ensure occupational safety among medical staff by using comprehensive measures based on nosocomial infection management system.MethodsAll the reported cases of occupational exposure were retrospectively collected from August 2012 to July 2018. The cases were divided into the control group (from August 2012 to July 2015) in which the data were reported in paper, and the observation group (from August 2015 to July 2018) in which the data were reported by nosocomial infection management system. The report and follow up results of occupational exposure in the two groups were compared and analyzed.ResultsAfter three years application of nosocomial infection management system, the occupational exposure report increased 95.8% (increased from 16.7 cases per year to 32.7 cases per year); the follow-up ratio of occupational exposure after one month,3 months and 6 months increased from 65.0% to 93.3% (χ2=15.184, P<0.001), 45.0% to 73.3% (χ2=9.033, P=0.003), and 25.0% to 53.3% (χ2=8.522, P=0.004), respectively.ConclusionApplication of nosocomial infection management system can increase the report of occupational exposure and the follow-up ratio of occupational exposure significantly.
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.
Objective To evaluate the effect of ECRS management model on the quality of prevention and control of hospital infection with multidrug-resistant organisms (MDROs). Methods The data related to the prevention and control of MDROs in the First Hospital of Nanchang in 2020 and 2021 were retrospectively collected. The hospital implemented routine MDRO infection prevention and control management in accordance with the Expert Consensus on the Prevention and Control of Multi-drug Resistant Bacteria Nosocomial Infection in 2020. On this basis, the hospital applied the four principles of the ECRS method to cancel, combine, rearrange and simplify the MDRO infection prevention and control management. The detection rate of MDROs on object surfaces, the incidence rate of hospital infection of MDROs, the compliance rate of hand hygiene, the implementation rate of contact isolation prevention and control measures, and the pass rate of MDRO infection prevention and control education assessment were analyzed and compared between the two years. Results The detection rate of MDROs on the surfaces in 2021 was lower than that in 2020 (9.39% vs. 31.63%). The hospital-acquired MDRO infection rate in 2021 was lower than that in 2020 (1.18% vs. 1.46%). The hand hygiene compliance rates of medical staff, workers and caregivers in 2021 were higher than those in 2020 (90.99% vs. 78.63%, 73.51% vs. 45.96%, 70.96% vs. 33.71%). The implementation rate of contact isolation prevention and control measures in 2021 was higher than that in 2020 (93.31% vs. 70.79%). The qualified rates of MDRO infection prevention and control education in medical personnel, workers and caregivers in 2021 were higher than those in 2020 (96.57% vs. 81.31%, 76.47% vs. 47.95%, 73.17% vs. 34.19%). All the differences above were statistically significant (P<0.05). Conclusion ECRS management mode can improve the execution and prevention level of MDRO hospital infection prevention and control, and reduce the incidence of MDRO hospital infection.
As an important tool for nucleic acid detection of variant strains of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the mobile air capsule construction laboratory is a key medical resource in the prevention and control of COVID-19. Medical staff, security guards, cleaners, maintenance workers and volunteers in the mobile air capsule construction laboratory have high contact frequency with the samples, so they have a high risk of infection with COVID-19. In order to reduce this risk, this article discusses the infection management measures in the aspects of wearing and taking off personal protective equipment, environmental health management, post use goods management, medical waste management, staff training management and disposal process after occupational exposure, and analyzed the common problems in operation, based on the operation process of Nanchong mobile air capsule construction laboratory. The purpose is to provide a reference for the construction and management of other mobile air capsule construction laboratory.
Objective To understand the current situation of nosocomial infection management quality control centers at the municipal and county levels in Guizhou, so as to provide measures for promoting the construction of nosocomial infections management quality control centers at all levels in Guizhou. Methods From September 26th to October 12th 2023, based on the mobile network platform survey questionnaire of the infection prevention and control workshop, a survey was conducted on the establishment, personnel, information technology level, management, and quality control work of the nosocomial infection management quality control centers at the municipal and county levels in Guizhou. Results Nine prefecture-level cities/autonomous prefectures in Guizhou had established municipal-level nosocomial infection management quality control centers. The professional background of the staff at the municipal and county-level quality control centers was mainly nursing (accounting for 36.4% and 58.4%, respectively), and their educational background was mainly undergraduate (accounting for 70.5% and 83.3%, respectively). No quality control center at the municipal or county level had established an information-based quality control platform for nosocomial infection management within the region. Most county-level quality control centers did not have special funds (87.5%), and there were still 16 (25.0%) county-level quality control centers that had not established relevant systems for work and management. The main forms of quality control work carried out by each center were organizing training, on-site inspections, guidance and evaluation, and most of them were conducted irregularly. Conclusions Guizhou has basically formed a quality control system for nosocomial infection management at the provincial, municipal, and county levels. However, the nosocomial infection management quality control network has not fully covered all districts, and policies, funding support, and personnel allocation are still insufficient. Health administrative departments and quality control centers at all levels need to unify monitoring standards and quality control norms, strengthen supervision, improve quality control capabilities, and improve training systems to achieve standardization and normalization of quality control work throughout the province and improve quality control efficiency.
Wound infection can prolong wound healing time, increase hospitalization cycle and readmission rate, seriously affect patients’ quality of life and increase economic expenditure. Timely and accurate identification and management of wound infections is key to promoting wound healing and maximizing cost-effective management. In 2022, the International Wound Infection Association published the third edition of Wound Infection in Clinical Practice: Principles of Best Practice. The consensus incorporates new advances in research and clinical practice in the areas of wound environment, risk factors for infection, biofilms, antibiotic resistance, and the identification and management of wound infections, and provides detailed approaches to infection assessment and management. This article introduces the key elements of the 2022 expert consensus and interprets the updated content to help healthcare professionals, patients, caregivers, and policy makers understand the latest consensus document, promote its clinical application in the prevention and treatment of wound infection, and better improve the quality of clinical practice.
Objective To study the effect of training methods for hospital infection management that through the whole process of diagnosis and treatment. Methods We selected part-time hospital infection personnel from Panyu Central Hospital of Guangzhou to form a teaching staff between January 1 and October 31, 2022. The teaching staff was randomly divided into a control group and an experimental group using a random number table method. The control group received training using traditional theoretical training models, while the experimental group received training using a simulated hospital infection training teaching model that runs through the entire diagnosis and treatment process. The training effects of the two groups through theoretical knowledge assessment, operational skills assessment, and teacher satisfaction evaluation were compared. Results A total of 196 teachers were included, with 98 students in each group. There was no statistically significant difference between the two groups in terms of gender, age, education level, major category, professional title, and years of work experience (P>0.05). The total score of theoretical knowledge examination in the experimental group [(88.49±8.33) vs. (80.35±13.57) points, t=5.062, P<0.001] was higher than the control group. Among them, the scores of hand hygiene standards for medical personnel, principles of aseptic operation, occupational exposure disposal, classification and disposal of medical waste were significantly higher than those of the control group (P<0.05). The total score of the operational skills assessment in the experimental group was higher than that in the control group [(86.37±5.25) vs. (76.75±7.07) points, t=10.811, P<0.001], among which the scores during operation, after operation, and overall impression were significantly higher than the control group (P<0.05). The overall satisfaction in the experimental group was higher than that of the control group (94.90% vs. 72.45%, χ2=18.076, P<0.001), among which the satisfaction with training methods, textbook value, course attractiveness, and clinical applicability were higher than those of the control group (P<0.05). Conclusions Through the whole process of diagnosis and treatment training method for hospital infection management can significantly improve the training effectiveness of teachers. It is worth promoting in the teaching of hospital infection management for various levels and types of personnel.