北京市重症医学科导管相关血流感染监测方法调查研究

Abstract

目的 了解北京市重症医学科开展导管相关血流感染监测的现状,为标化监测方法、定义、流程提供基线数据.方法 2014年12月采用流行病学横断面调查的方法,通过整群抽样,北京市医院感染质量控制与改进中心、北京市重症医学质量控制与改进中心对纳入北京市重症医学质量控制与改进中心管理的28家医疗机构的重症医学科开展调查.结果 回收54份调查问卷,回收率为100.00%;参与调查的医护人员职称构成以中级职称为主,占57.4%;学历构成以大学本科为主,占46.3%;导管相关血流感染千日导管发病率计算公式中的分子数据来源于医师采集,占68.5%,分母数据来源于科室记录占68.5%;79.6%的调查对象认为应由临床医师确诊医院感染,应通过"临床诊断+病原学结果"确诊CRBSI或CLABSI的比例为94.4%.结论 北京市重症医学科导管相关血流感染的监测方法、定义、流程未标化、统一,很难评价监测数据的质量和准确性、无法进行区域间数据的比较、更无法评价防控措施的效果.

OBJECTIVE To understand the actual state of surveillance of central line-associated bloodstream infections (CLABSI) in ICU in Beijing, so as to provide baseline data for standardizing surveillance methods, definition and processes.METHODS In Dec.2014, using the cross-sectional study method of epidemiology and cluster sampling, Beijing Nosocomial Infection Quality Control and Improvement Center and Beijing ICU Quality Control and Improvement Center conducted a survey on the ICUs of 28 medical institutions included in management of Beijing ICU Quality Control and Improvement Center.RESULTS Totally 54 questionnaires were recovered, with the recovering rate of 100%.The structure of the surveyed medical care personnel in respect of title was dominated by medium-grade professional titles which accounted for 57.5%, and structure in terms of education background was dominated by undergraduate education which accounted for 46.3%.Of the formula for calculating the 1000 day catheter-related incidence of CLABSI, the molecular data from collection of the doctors accounted for 68.5% and the denominator data from department records accounted for 68.5%.Totally 79.6% of the respondents considered that nosocomial infections should be diagnosed by clinicians and those believing CRBSI or CLABSI should be diagnosed through "clinical diagnosis +etiologic test results" accounted for 94.4%.CONCLUSION The surveillance methods, definition and processes of central line-associated bloodstream infections in ICU in Beijing have not be standardized and unified, so it is difficult to evaluate the quality and accuracy of the surveillance data and unable to make inter-regional comparison on the data, even not to mention evaluating the effects of the prevention and control measures.