The Study On The Construction Of Risk Assessment Tool For Surgical Wound Infection And Clinical Application Research

Purpose To provide a scientific basis preventing infection after surgical wound,this paper introduces a assessment tool which is built in accordance with characteristics of surgery patients in our country and current medical level.It aims to locate the high-risk population,remind the doctors and nurses to take preventive measures in time,strengthen the health education of patients,improving their compliance.Method Construction of risk assessment tools.On the basis of literature available,experts semi-structured interview and the latest surgical wound infection guidelines,the basic framework of surgical wound infection risk assessment tools were built.,The initial scale was set up after two rounds of assessment items formulation,screening and modification by Delphi expert cousultation.1.Reliability and validity test.From May 2017 to June 2017,the reliability and validity of scale was tested on 232 patients,from a hospital of Hunan Province,by surgical wound infection risk assessment survey with method of convenient sampling.2.The predictive value of surgical wound infection diagnosis.From July 2017 to December 2017,1017 patients with open surgery in a Hunan hospital were selected to analyze and collect clinical data by random sampling.The diagnostic criteria of hospital infection issued by the ministry of health at 2001 were used as the diagnostic gold standard group,and the diagnosis value was evaluated by surgical wound infection assessment scale.The predictive value of the ROC curve evaluation scale for surgical wound infection was plotted,and the optimal truncation value was selected by the Youden index.SPSS 18.0 software was used for statistical analysis of the data,and the measurement data was expressed by mean and/or standard deviation((?)±s).Results 1.Expert consultation results.This study consulting 21 experts from six cities of Hunan,Guangdong,Guangxi three provinces,all are engaged in the relevant work of the surgical site infection.The expert's experience and professional titles,educational background represent their fields of professions and geographical regions.Their professional fields are distributed in clinical treatment of 17 people,1 clinical surgical nursing,2 nursing management,1 hospital infection.The positive coefficient of the two rounds of expert consultation is 84% and 100% respectively.The personal authority coefficient of experts is greater than 75%,and the authority coefficient of experts is 0.86.The kendal concordant coefficient(W)of the two rounds of expert opinion was 0.450 and 0.441 respectively(both of which have statistical significance p < 0.05).The two rounds of expert text recommendations are 26 and 5 respectively,and the final evaluation system index includes 4 primary indicators and 10 indicators.2.Surgical wound infection risk assessment scale reliability and validity test results.The scale contains 20 items in four dimensions and explains 80.913% of the total variation.The coefficient of Cronbanch's ?is 0.914,the content validity are 0.823 and 0.950.3.Surgical wound infection assessment scale was used to predict the diagnosis of open surgical wound infection.Among the 1017 patients,13 were infected,and the non-infection group people were 1004.There was no statistically significant difference between the two groups(p>0.05),while the scale score between the two groups were statistically significant(p<0.05).The higher the scale score is,the greater the possibility of surgical wound infection is.Under the ROC curve of the scale,the area(AUC)was 0.905±0.039(95%CI: 0.829~0.981),and the optimal cut-off point was 33.5,while the diagnostic sensitivity of surgical wound infection was 84.62%,and the specificity was 83.37%.Predictions with a degree of accuracy above 80%.Conclusion This research investigated the risk assessment tool for surgical wound infection,through the Delphi expert consultation as well as the large sample test,reliability and validity of the tool structure is reasonable,stable and scientific.It showed higher predictive value for the risk of wound infection in patients with open surgery.It conforms to the characteristics of people in our country,has good practicability and feasibility.It is suitable to be used as an assessment tools for patients with open surgery infection risk in China,for the purpose of screening patient at high risk of infection and assessing risk factors of infection.It also provides reference to prevent and reduce infection,thus to improve patient's safety.