| BackgroundCommunicable diseases prevention and control is one of the most important task of public health, which is not only related to social development and people's well-being directly, but also act as a mainly indicator for the evaluation of the overall socio-economic and health-care development level in countries or regions. With the rapid growth of China's economy, people's living standards, health conditions and living environment are becoming continuously improved, particularly a number of lethal infectious diseases, which could damage health seriously, have been constaind successfully. However, attacks resulted from communicable diseses on human case still occur frequently, such as the pandemic of SARS in 2003, the epidemic of Anaplasmosis and the subsequent outbreak of HFMD in Anhui province in 2006, and even in recent years the spread of H5N1. The general hospitals have been one of the primary responsible agencies against infectious diseases in China, which could be able to detect the outbreaks of infectious diseases earlier and always in the forefront of clinical treatment. But there is neither research for general hospitals on the risk of nosocomial spread of infectious diseases, nor systematic evaluation of research reports on the comprehensive capable on the prevention and control of infectious diseases of general hospitals.Objectives1. In-depth investigation on the secondary and tertiary hospitals on the status of prevention and control for infectious diseases;2. Find out the risk factors of nosocomial spread of infectious diseases and the risk distribution status, in order to know the reasons for the risk factors;3. Make a comprehensive evaluation of the general hospitals'ability on prevention and control for infectious diseases, in order to provide the basis of infectious diseases prevention and control work.MethodsA multiple approach with a comprehensive literature review and expert-scored method was used to develop an indicator system framework to evaluate hospitals'ability against infectious diseases. A questionnaire was designed to survey the current status of secondary- and tertiary-general hospitals all over China. According to the survey results, the prevention and control ability evaluation model was developed using the factor analysis. Conducting comprehensive evaluation of the model of comprehensive hospitals'capable of infectious diseases prevention and control. On this basis, we can give further proposals on strengthening the capacity-building on infectious diseases prevention and control in general hospitals.Results1. The status of infectious disease prevention and control in general hospitals is composed of the basic situation of general hospitals, section of infectious diseases, settings of infectious diseases wards, personal protective equipment, detection and reporting on infectious diseases, hospital management, monitoring and management on the nosocomial infection, laboratory biosafety and training and exercise, which has a total of eight dimensions and 48 specific items.2. The risk factors of transmission of infectious diseases including infectious diseases wards, the respiratory tract (fever) out-patient clinics, pediatric clinics, outpatient infusion room, entric diseases clinics and wards, endoscopy room, operating room, department of stomatology, biological specimen collection and testing, hospital equipment to provide hand-washing and waste disposal, which has a total of 11 dimensions and 81 specific targets.3. The results of the survey suggested that: in recent years, the work of infectious diseases prevention and control in general hospital has been considerable improved, especially after the SARS, the detection, report and survillace on the epidemic situation of infectious diseases has been made in the corresponding grade. However, ward district of infectious diseases section, hand-washing facilities, as well as disinfection and waste disposal, which have poor performance.4. A hospitals'CPHEP evaluation model was developed based on the factor analysis as follows: C = 0.639C1 + 0.191C2 + 0.170C3 where C is a prevention and control ability score, C1 is a capacity score for material stockpile at hospitals; public health emergencies at hospitals, C2 is a capacity score for detection and recognition of infectious diseases, C3 is a capacity score for management.5. Application of the comprehensive evaluation model to evaluate the comprehensive capacity to prevent and control infectious diseases found that the status: general hospitals have different abilities on comprehensive infectious diseases prevention and control. The tertiary hospitals appear better than the secondary's. ConclusionsThis study is the first comprehensive and systematic investigation of general hospitals on the infectious diseases prevention and control. A comprehensive evaluation model was estblished for different types of hospital capacity of preventing and controlling infectious diseases. At the same time, we made further analysis of the existing problems on importance and the infectious diseases prevention and control measures and put forward to strengthen its measures related to the construction, in order to strengthen the infectious diseases prevention and control system and provide a basis for construction of general hospital. The main innovation has contributed to:1. To carry out the domestic general hospitals nationwide nosocomial investigation for the first time on risk factors for the transmission of infectious diseases, and hope to reveal the possible infectious cause of potential risks in general hospitals;2. To set up a comprehensive evaluation model on general hospitals on infectious diseases prevention and control. And use the model to evaluate the capacity of general hospitals. |
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