| ObjectivesNosocomial infection is formed with the birth of hospital and becomes more and more serious with the development of medicine.Nosocomial infection is the most important factor affecting the diagnosis and treatment effect and life safety of patients.The study of the time trend of the incidence of nosocomial infection is not only helpful to understand the current status of hospital infection,but also to understand whether there is a certain regularity in its changes,and then to evaluate the current health policy and the feasibility and effectiveness of hospital infection prevention and control measures.Its research has important guiding significance for future hospital infection control.At the same time,the hospital has advanced medical technology and large number of patients.Which infection prevention and control is closely following the trend of domestic hospital infection.Therefore,the purpose of this study is based on the real-time monitoring system of nosocomial infection,which continuously counts the nine-year average infection rate and the seven-day real-time infection rate in the hospital,to explore the time trend of nosocomial infection incidence,and understand the changes of nosocomial infection in China’s top general hospitals in recent stages,and evaluate the results of nosocomial infection prevention and control intuitively.Methodsl.Data collectionBased on the real-time monitoring platform of the Hospital Infection Management and Control Department we retrospectively investigated the annual infection data of all inpatients discharged from a large general tertiary A-level hospital in Beijing from July 2009 to My 2018,including wards,number of hospitalizations,average length of stay during observation period,total length of stay during observation period,the number of new infections in the same period,the overall situation and trend of nosocomial infection were observed.At the same time,the weekly infection data of the hospital were collected retrospectively,and the short-term incidence and trend of nosocomial infection were statistically observed2.Data collation and analysisEstablishment of database:data input and soiling through EXCEL software;Data processing:using SPSS22.0 statistical software for data statistical analysis.Survey results analysis:The adoption rate and composition ratio of the counting data were described.The comparison of the rate variance for the trend and difference.The test level a=0.001Nosocomial infection rate(%o)＝(specific time)the number of cases of nosocomial infection÷the number of patients at risk of infection during observationx 1000%oCase rate of infection in the same period＝Number of the time cases of infection during the same period÷the number of patients at risk of infection during observationxIOOOVoOThe composition ratio of nosocomial infection=Number of observation units for a component÷Number of observation units for each component of the same thing× 100%ResultsA total of 131 979 discharged patients were investigated during the period of 2009.7-2018.7.During hospitalization 28866 cases of infection occurred.The infection case is 37106 times.The hospital infection rate was 12.02‰,21.13‰,19.14‰,25.00‰,25.56‰,22.87‰,24.58‰,21.73‰,20.56‰.There was a slight increase of nosocomial infection.There is a similar phenomenon in the case rate of infection.At the same time,the total number of hospitalized patients in the hospital has also increased in the past years,but the average length of stay per capita has a downward trend.The incidence of infection has been tested by trend chi-square,χ2=722.36,P<0.001,with statistical differencesInpatients were classified according to different departments.During the survey,the number of patients in different departments varied greatly in different years.Among them,the total number of medical patients was 74,270,the total number of surgical patients was 73,888,the number of outpatients was 3920,and the total number of patients in other departlents was 30,872.The RXC chi-square test value was 20410,and P<0.001 with the statistically significantThe patients were classified according to different departments and their infections were counted.The infection rate of the patients in the Department of internal medicine and hematology was the highest(317 persons),accounting for the largest proportion(11.92%)of the total infected persons.The number of internal medicine respiratory infections is 208 with the lowest ratio(7.82%).The lowest number of medical insurance infections is 9(0.1 1%).The incidence of infection was 110.22‰ in the department of Hematology,followed by 61.12%o in the department of Internal Medicine,70.15‰ in the depart1ent of Internal Medicine,and 66.58%0 in the department of Internal Medicine.In surgical infection,the highest level of neurosurgery was 51.58‰,and the minimum inpatient department was 0.67‰.The incidence of infection in otlher departments remained at a relatively low level of stability.At the same time,the chi-square test was performed on the infection of different departments in the year,y2＝855.36,P<0.001.The difference was statistically significantThe overall situation of hospital infections and the incidence of infections in various departments duinng the study period included intermal medicine,surgery,outpatient clinics,other departments(intensive care unit,special inpatient department,medical technology department intermational medical departlent rehabilitation medicine department etc.)below 30%0 has tlhe same time trend,among which the incidence of infection in internal medicine is the highest.The incidence of nosocomial infections in the departlents of January-February and October 7th showed a large increase.The incidence of infections in other months was relatively low,and the incidence of outpatient infections was the most obvious.During the national statutory holidays,such as the Spring Festival,Qingming,Labor Day,Dragon Boat Festival,Mid-Autumn Festival,New Year’s Day,etc.,there has been a slight increase,but the trend of change is relatively small compared with the Spring Festival and National Day.There was no significant change in the incidence of nosocomial infections during non-state legal holidays.It can be seen that the incidence of nosocomial infections is significantly correlated with holidays.Analysis of variance of weekly infection rate in the whole hospital over the years,found that F=45.218,P<0.001,the difference was statistically significant.Along them,the highest rate of 52 weeks of infection in the past years was 25.47%o,which was also lower than the 30‰ prescribed by China.The weekly infection rate of 2011.7-2012.7 was lower at the lowest level of only 13.03%o,which showed the same trend as the annual infection incidence.Conclusion1.2009.7-2018.7 The infection rate of nosocomial infection has a certain small increase trend for 9 consecutive years and finally stabilized at around 20‰,indicating that the hospital has paid considerable attention to the sense of control in recent years and its prevention and control measures have achieved certain effect.2.The number of inpatients in different departments in different years 15 not exactly the same.The hospital should make reasonable planning for tihe hospital ward according to the patient,s condition and allocate medieal resources reasonably.3.Internal medicine,surgical ilfections have the highest incidence,and other departments remain at relatively low levels.For departments with high incidence of nosocomial infections,especially respiratory medicine,infection monitoring should be strengthened,science of infection prevention and control knowledge should be enhanced,and ward disinfection and hand hygiene of medical workers should be strengthened.4.The infection rate of the whole hospital is below 30 per week,which has the same trend with other departments such as internal medicine and surgery,and has obvious correlation with holidays and seasons.5.The pathogenic bacteria of nosocomial infection increased continuously during the investigation period,and Gram-negative bacteria were the main pathogenic bacteria. |
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