Large General Hospital Infection Factors And Countermeasures

Background:Hospital infection administration is in accordance with the hospital in the medicaldiagnostic process of emerging infections and other objective laws, theories and methods ofusing the phenomenon of hospital infection to plan, organize and control activities, in orderto improve efficiency and reduce infection. In recent years, as efficient, broad-spectrumantibiotics and immunosuppressive agents, long-term, widespread use, coupled withchanges in disease spectrum and the aging population continues to increase, a large numberof invasive treatment techniques to carry out a variety of factors, hospital infection rates arerising trend, which not only increases the patient's hospital stay and costs, reduce bedturnover rate, increase the workload of medical staff, but also for the safety of patients alsoconstitute a serious threat. Domestic and foreign hospital infection events to be reported,not only severely restricted the quality of care improvement, interferes with the harmoniousdevelopment of the hospital, but also to the rehabilitation of patients with medical treatmentand disease pose a major security threat. Hospital infection has an impact on the level ofhospital care, hospital efficiency and competitiveness of an important factor in the worldtoday is increasingly causing health administrative departments at all levels, and hospitalmanagers are highly valued.Hospital infection administration is an important part of hospital quality management,is one of the most important medical safety ring. With the deepening of hospital infectioncontrol, management, content is gradually institutionalized and legalized and standardizedforward. September1,2006, issued by the Ministry of Health,"Hospital Infection ControlMeasures," the official implementation, indicates that China has entered a hospitalinfection control legal construction of the track. As modern medical technology is stillgrowing rapidly, the problem of hospital infection is still very prominent and complex. The changing face of hospital infections, as a comprehensive health care, teaching and researchcapacity of the regional, provincial, municipal and delivery of health services across thecountry to a large general hospital, will face more challenges.Objects:This study of a large general hospital inpatient hospital infection characteristics,epidemiological characteristics and the factors affecting the investigation and analysis ofhospital management to provide a comprehensive hospital infection status, so as to furthereffective prevention and control of hospital infection development of effective hospitalinfection control measures to reduce the incidence of hospital infection, avoiding outbreaksof hospital infection, protect the health safety and improve hospital infection controlstandards and provide a theoretical and practical reference.Methods:This study is a case study. Through quantitative surveys, the use of hospitalnosocomial infection surveillance software database of nearly five years of data, analysis ofthe incidence of nosocomial infection, the use of statistical method of hospitalinfection-related indicators, reflecting the overall characteristics of data, analysis of internalrelations of things and laws; through qualitative survey, using focus group discussions andindividual depth interviews to understand the factors of nosocomial infection, the scientificevaluation of a large and integrated management of hospital infection status, problems andweaknesses, and propose appropriate management strategies. The method is qualitativeresearch in hospital infection control under the guidance of a "qualitative quantitativestatistics,"especially on hospital infection management in the patient to explore two factors,analysis of a large general hospital infection control characteristics, distribution rules andfactors.Results:1Quantitative results1.1The incidence of nosocomial infectionResearch hospital from2006to2010,266,514cases of hospitalized patients, thehospital's nosocomial infection rates were3.53%,3.25%,2.78%,2.67%,2.42%, an averageof2.86%. Five years, the incidence of nosocomial infection decreased year by year, thedifference was statistically significant (X2=153.25P=0.000). 1.2False negative rate of hospital infectionHospital for2006to2010to compare the false negative rate of infection and foundthat the false negative rate in2006and2007, higher, respectively,25.92%and15.80%;2008,2009,2010a declining trend, were9.95%,6.19%,6.48%.2006to2010the falsenegative rate of nosocomial infection was significantly (X2=194.82P=0.000).1.3Parts of the distribution of hospital infectionsIntegrated from2006to2010the incidence of hospital infection of the main parts, thelower respiratory tract infection in susceptible parts of the composition ratio in the firstaccount (3116cases, accounting for35.52%); followed by upper respiratory tract infection(1462cases, accounting for16.67%); urinary tract infections (1174cases, accounting for13.38%); gastrointestinal tract infection (808cases, accounting for9.21%); surgical siteinfections (763cases, accounting for8.70%); cavity infection (605cases, accounting for6.90%); bacteremia (413cases, accounting for4.71%); other infections (278cases,accounting for3.17%).1.4Hospital infection and the relationship between patient ageIn this study, infected patients, the youngest3days, maximum98years old, average50.36years of age. After the60-year-old age group the incidence of nosocomial infectionthan60-year-old age group was significantly higher before age20compared with60infantsand children after the age of the age group of hospital infection rate is low, but higher thanthat between the ages of20to50age group, showing no rules "U"-type features. Testbetween the different age groups the incidence of nosocomial infection significantlydifferent (X2=2463.51P=0.000).1.5Hospital infection and the relationship between the time the seasonYear, month by month statistics of hospital infection rates, found the highest incidenceof nosocomial infection is the month of August, to3.26%, the lowest for the month of Mayis2.53%, other2%in the month prevalence~3%.1.6Hospital infection and hospitalization days7627cases of hospital infection, the hospital stay less than7days, the number of casesto1214cases of infection, the infection rate was0.96%;15days the number of cases to3490cases of infection, the infection rate was6.46%;30days the number of cases ofinfection in2321cases, the infection rate was24.93%; greater than60days the number of cases to645cases of infection, the infection rate was50%. Inpatient hospital time waspositively correlated with infection rates, length of stay of60days was significantly higherin patients with infection.1.7Hospital infection and surgical7627cases of hospital infections,4659cases have surgery, the infection rate was3.63%;3032cases without surgery, infection rate was2.16%. The X2test, the differencewas statistically significant (X2=530.54, P=0.00).1.8Hospital infection and distribution departmentsThe survey of hospital infections in different sections of the hospital infection ratebetween the different, in which blood medicine, neurology, burn unit of the hospitalinfection rate for the first three, followed by17.25%,6.67%,6.43%, the incidence ofhospital infections at the back of three of the obstetric, ENT, ophthalmology, were0.91%,0.71%,0.31%.1.9Hospital infection and pathogen distribution2006to2010received a total of122,744clinical specimens were cultured pathogenicmicroorganisms, bacteria isolated from29560, the detection rate of24.1%, Gram-negativebacilli2058469.6%, Gram-positive cocci accounted for30.4%of8976. The number ofhospitalized patients bacterial isolates in the top ten, top Acinetobacter baumannii,16.6%;Escherichia coli, accounting for16.5%; Pseudomonas aeruginosa, accounting for13.7%.1.10Clinical use of antibiotics in general quantitative indicatorsPer capita use of antibiotics in patients hospitalized a few varieties of3.05; hospitaluse of antibiotics per patient cost of1809.12yuan; hospital use of antimicrobial drugs inpatients with the percentage of60.70%; antimicrobial drug use intensity70.08; antibacterialdrug costs accounted for the percentage of the total drugs to10.53%; special varieties ofantibiotics accounted for use of antimicrobial agents using the percentage of the amount of4.04%; hospitalized patients with antimicrobial agents pathogenic examination percentageof16.39%.2Qualitative findings2.1Hospital management organization system to be optimized;2.2Hospital leadership emphasis on hospital infection control is still not enough;2.3Hospital infection control professionals team needs to be strengthened; 2.4Clinical departments of the hospital infection control knowledge is still inadequate;2.5Hand hygiene, hospital canteens of water and sanitation issues to be valued;2.6Medical staff of occupational safety issues to be concerned about;2.7The role of clinical microbiology laboratories need to continue to strengthen.Conclusions:1. Hospital infection and patient age, underlying diseases, invasive operation, hospitalstay, antibiotics do not Fair use and other factors.2. Hospital patients will increase the financial burden and prolong the average lengthof stay, and reduce the turnover rate of hospital beds and medical resource utilization.3. Establishment of an effective hospital infection management, provide a strong legalguarantee system is to prevent and control hospital infections important guarantee.4. A rapid and accurate monitoring system of hospital infection, hospital infectioncontrol is good, to improve the efficiency of effective hospital infection control methods.5. Establish an effective mechanism of information transmission and communication,make full use of internal risk in all the favorable factors, the risk of hospital infectioncontrol is the basis for the work.6. The establishment of a rational structure of hospital infection control team, tostrengthen the knowledge of hospital infection hospital training is the core of good infectioncontrol.7. Clinical use of antibiotics to establish the regulatory system to prevent irrational useof antibiotics is the hospital infection prevention and control of important aspects.8. Central sterile supply can be traced back to establish the management system,hospital infection control and effective measures of continuous quality improvement.