Cross-sectional Investigation And Strategy Analysis Of Nosocomial Infections Administration

Study BackgroundNosocomial infection is one of the difficult problems in hospital managementnowadays, which affects the medical quality. Extensive application ofimmunosuppressive agent, more device utilization, the unreasoned use of antibioticsand the aging of society brought on nosocomial infection increasing gradually withthe development of modern medical technologies. The annual direct economic loss inour country is 10 to 15 billion yuan. The number cannot be estimated if indirecteconomic loss were included. About 2 million persons caught nosocomial infectionsin America annually, which caused 44 to 98 thousand persons dying and 17 to 29billon $ losing. Therefore, nosocomial infection has been a big problem of publichealth at present, and we should pay more attention to it.ObjectivesTo study 32046 cases of January to December, 2005. Retrospective investigationof infection time, age, locations, departments and bacteria species was carried out. Toinvestigate the nosocomial infection rates and characteristics so as to exploreeffective preventive measures. The trends of incidence rate of nosocomial infections,the constitutes of infection departments, the distribution of pathogens and the use of antibiotics were analyzed to estimate the nosocomial infection surveillance work andprovide scientific basis for decreasing the occurrence of nosocomial infections andperfecting the Chinese NNIS System.MethodsThe 32046 inpatients were monitored by retrospective investigation in threeClassⅢ, RankⅠHospitals of Urumqi. The data of the patients discharged fromJanuary to December in 2004 were collected to be analyzed.The diagnosis standard was the Nosocomial Infection Criterions formulated bythe Nosocomial Infection Surveillance and Control Cooperative Group, the HealthMinistry, the People's Republic of China.Results1. 32046 hospitalized patients were surveillanced from January to December in2004. 1128 nosocomial infection patients discharged from among the surveillancehospitalized patients, and the total nosocomial infection incidence rate was3.52%.The total missing report rate ofnosocomial infection was 25.2%.2. The military hospital nosocomial infection incidence rate was 3.85%, andmissing report rate of that was 27.9%.The local hospital nosocomial infectionincidence rate was 2.97%, and missing report rate of that was 19.3%. The differenceof nosocomial infection between the military hospital and the local hospital wassignificant (P＜0.01),and the difference of missing report rate between them wassignificant too (P＜0.01).3. the highest one of nosocomial infection rates was September in a year, and thelowest one was June. The differences among time-group infection rates were nosignificant (P＞0.05).4. Age distribution (years): 0～, 10～, 20～, 30～, 40～, 50～, 60～. Thenosocomial infection incidence rates of each age-group were 3.47%,3.46%, 2.81%,2.96%,3.25%,3.37%,4.58%, respectively. The differences amongage-group infection rates were significant(P＜0.01).5. Department Distribution: the infection incidence rates of the Department ofgeneral surgery, empyrosis and cardioangiology departments were5.48%, 5.32%,5.28%.The differences among the department infection rates were significant(P＜0.01).6. The infection rate for lower respiratory tract was highest in the allNosocomial infection locations. The other commonly involved locations ofNosocomial infection were upper respiratory tract, urinary tract, surgical sites,gastrointestinal tract.7. Gram-negative(G~-) bacilli (61.8%), Gram-positive (G~+) bacterium (22.9%)and fungi (15.3%) were found in clinical cases who were infected, and bacillus coil,pseudomonas aeruginosa and staphylococcus aureus was 13.57%, 12.06% and 9.55%respectively.Conclusions1. The total nosocomial infection incidence rate was 3.52% and the totalmissing report rate of nosocomial infection was 25.2% in Urumqi.2. The nosocomial infection rate and missing report rate of military hospitalwere higher them of local hospital.3. The Nosocomial infection rate of September was the highest in a year inUrumqi.4. The Nosocomial infection rate of old patients was higher than the others.5. Nosocomial infection obviously happened in general surgery, empyrosis andcardioangiology departments.6. the most commonly involved sites of Nosocomial infection were respiratorytract, urinary tract, surgical sites, gastrointestinal tract. 7. Gram-positive (G~-) bacterium, especially bacillus coli, was the majorpathogens for nosocomial infection.This analysis results of the Urumqi three hospital investigation indicated that thehospital infection percentage and the rate of missing report question were still theresult of which the control system not perfect and the control do not arrive.Therefore,it must strengthen the organization to perfect system, strictly according tostandard monitor. The main easy feeling crowd, the key administrative offices, thekey spot and the bacteria colony had been controlled according to its infection reasonand the morbidity rule. The standard antibiotics medication drafted, the medicineapplicator disinfection quality guaranteed, medical care personnel's hand healthmanaged, the hospital hardware facility construction strengthened, the reasonablescience ward established, the hospital infection management the hospital qualitycontrol system merged. The hospital infection monitoring fully displayed andeffectually control.