| Purpose:This study aims to explore a model for improving the implementation capacity of hospital infection prevention and control in the context of public health emergencies,analyse the current situation and working mechanism of hospital infection management implementation in public hospitals,mainly tertiary hospitals,in the context of the normalisation of new epidemics,establish a scientific model that can improve the capacity of hospital infection prevention and control in the context of public health emergencies,and construct a universal hospital infection management evaluation It also constructs a universal hospital infection management evaluation system and summarises the shortcomings and possible challenges of hospital infection management in public hospitals in their daily work and response to public health emergencies.Improvements to the existing hospital infection management programme are proposed to provide some scientific basis for establishing a regional standardised management system for quality control of hospital infection management.Methods:This study combines qualitative and quantitative research methods from sociology,mainly using a mixed research method of Grounded theory,the Delphi method and the Analytic hierarchy process coupled with the Entropy weight method.Interviews were conducted,data collected from key informants of hospital infection management capacity through purposive sampling combined with snowball sampling,and qualitative analysis of the interview data was conducted word by word using Nvivo12 software based on the principle method of Grounded theory.The model of hospital infection management capacity enhancement was constructed accordingly.Based on this model,a Delphi method was used to conduct expert consultation,screen,modify and determine the three-level index system.Finally,the weights of each index combination were coupled and calculated to construct a three-level index evaluation system for hospital infection management capacity enhancementResults:1.Conclusion of the qualitative study of the Grounded theory:After the information saturation test,77 open codes,28 main axis codes and six selective codes were obtained by coding the interview data in three levels of the Grounded theory.A model of hospital infection management competency enhancement was obtained after the information saturation test.The model showed that hospital infection management capability was positively influenced by hospital infection management system and regulation,hospital infection management awareness and philosophy,hospital infection management system and division of labour,hospital infection management operational capability,hospital infection management outcome assessment and hospital infection management emergency response capability,and all of the above dimensions could improve hospital infection management capability.2.Hospital infection management capability evaluation index system:A preliminary framework of the hospital infection management capability evaluation index system was developed based on the interview results combined with the rooting theory model.27 experts in the field of hospital infection management were invited to conduct two rounds of consultation on the importance and accessibility of the indexes.The authority degree of experts in the two rounds was 0.875 and 0.859,respectively,with positive coefficients of 96.29%and 100%,respectively.In the second round,the Kenda11 harmony coefficients of indicators at all levels were improved compared with the first round.A hospital infection management capacity evaluation index system comprising 6 primary indicators,18 secondary indicators and 69 tertiary indicators was finally determined,and the weights of each indicator were explicitly calculated.Among the primary indicators,the highest weight was given to the assessment of hospital infection management results(W=0.2789),while the lowest weight was given to the hospital infection management mechanism and standard(W=0.0918);among the secondary indicators,the highest weight was given to hospital infection control training(F1)(W=0.1412);among the tertiary indicators,the top five indicators with the highest weight were the definition and management of crucial risk departments(A2-The top five indicators with the highest weight were the definition and management of crucial risk departments(A2-2),the level of informationization of hospital infection management(D3-1),the key items for prevention and control of hospital infection(A1-3),the development and implementation of infection management rules and regulations and work practices that meet the characteristics of the hospital(B1-2),and the level of mastery of laws,regulations and rules on hospital infection management(A2-1),with weight values of W=0.0462,W=0.0433,W=0.0407,W=0.0362 and W=0.0337 respectively.Conclusions:The infection management capability of tertiary hospitals in China has been continuously improved in recent years,and the system and norms of hospital infection management have been gradually improved and popularized.However,the awareness and concept of hospital infection management still need to be further strengthened.The factors influencing the ability of hospital infection management are diversified,subjective and consciousness level are hospital infection management awareness and philosophy,objective and institutional factors are hospital infection management system and norms,hospital infection management system and division of labour,and more critical hospital infection management ability level are hospital infection management operational ability,hospital infection management result assessment,hospital infection management emergency handling ability.Hospital infection quality management control involves a wide range of contents and many indicators,and it is difficult to judge whether the overall hospital infection quality control has been improved by a single indicator.The hospital infection management capability evaluation index system constructed in this study can be used both to evaluate hospital infection management capability level and overall hospital infection management risk assessment of general hospitals.In the follow-up work,we should further strengthen the system construction of nosocomial infection management,strengthen the training and assessment mechanism,pay attention to cultivating personnel awareness and attitude,and improve the hardware facilities mainly based on information construction. |
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