ObjectiveTo investigate the prevalence of nosocomial infection in a hospital and to provide a basis for hospital infection control. MethodsUsing bedside investigation and medical records analysis, we surveyed all hospitalized patients from 00:00 to 24:00 on July 19th, 2013. ResultsThe real investigation was carried out on 1815 patients out of all the 1828 patients with a real investigation rate of 99.29%. There were 55 cases of nosocomial infection (55 case-times), and both the nosocomial point infection rate and case-time infection rate were 3.03%. The top three departments with the highest rate were Intensive Care Unit (37.50%), Neurosurgery Department One (13.73%) and Neurosurgery Department Two (12.00%). Most infections occurred on the lower respiratory tract, which accounted for 45.45%. Nosocomial infection pathogenic detection rate was 38.18% (21/55):6 cases of Staphylococcus aureus (28.57%), 5 of Pseudomonas aeruginosa (23.81%), 3 of Klebsiella pneumoniae (14.29%), and 2 cases of Acinetobacter baumanii (9.52%). The rate of antimicrobial drug use was 24.08%, in which drug treatment accounted for 75.29%. Gender, surgery, urinary catheter, vascular catheter, tracheostomy, ventilator application, hemodialysis, and use of antibiotics were all influencial factors for occurrence of nosocomial infection. ConclusionNosocomial infection prevalence survey can help fully understand the status of hospital infection, help to carry out targeted surveillance, and better guidance for hospital to prevent and control nosocomial infection.
Running an infection control regular meeting is an effective way to develop and improve the communication between the infection control team and clinical units. This paper introduces the infection control regular monthly meeting which is held in the last week of each month in a newly-opened branch hospital of a university teaching hospital in China. Through collecting the issues for discussion beforehand, feeding back the surveillance data of last month including nosocomial infection, hand hygiene, multidrug-resistant organisms, occupational exposure, and medical waste, discussing the current infection control issues from each ward and trying to solve them together, and delivering and sharing new knowledge, skills, and information in terms of infection control, the monthly meeting achieves remarkable successes in the aspects of promoting the hospital infection control-related cultural construction, enhancing the supervision and implementation of infection control measures, and running new projects on hospital infection management, etc. Infection control regular monthly meeting builds up a study and work platform, promotes the multidisciplinary and multi-department communication and collaboration, and improves the quality of infection control eventually.
Objective To understand the influence of organisational support and professional identity of hospital infection prevention and control (HIPC) practitioner in public hospitals. Methods HIPC practitioner of the public medical institutions secondary level and above in Neijiang City, Sichuan Province were used as the research object. A questionnaire survey was used to analyze their organizational support and professional identity in May 2022, to compare the differences in organizational support and professional identity among HIPC practitioner with different positions, working ages, and majors, and analyze the correlation between organizational support and professional identity among HIPC practitioner. Results A total of 90 valid questionnaires were retrieved from investigation. The average scores for organizational support and professional identity among HIPC practitioner were (3.409±0.625) and (2.518±0.504) points. Among them, the organizational support of intermediate professional title personnel [(3.155±0.785) points], personnel with 5-10 years of service [(3.071±0.696) points], and clinical physicians [(3.342±0.860) points] were the lowest; the professional identity of personnel with intermediate professional titles [(2.357±0.477) points], those with more than 10 years of service[(2.431±0.454) points], and other professionals [(2.471±0.260) points] were the lowest. The Pearson correlation analysis results showed that there was a positive correlation between organizational support and professional identity (r=0.490, P<0.05), self-identity and work support (r=0.364, P<0.05), and environmental identity and relationship interests (r=0.698, P<0.05). Conclusions Due to the low level of organizational support, there is a decrease in professional identity and significant job burnout, which in turn leads to an increase in the turnover rate of infection control professionals. Therefore, it is necessary to enhance the sense of organizational support for specialized personnel in infection control to promote their professional identity and stabilize the infection control team. Suggest providing necessary support at the organizational level and self-improvement at the individual level.
Objective To investigate the current status of occupational environment support, occupational satisfaction, and job competence of hospital infection prevention and control personnel, and to explore the mediating effect of occupational satisfaction on the relationship between occupational environment support and job competence, in order to provide reference and guidance for effectively improving the job competence of hospital infection prevention and control personnel. Methods A survey questionnaire was distributed to various levels and types of medical institutions in Shanghai through the platform of the Shanghai Hospital Infection Quality Control Center. The questionnaire included the Occupational Environment Support Scale, Occupational Satisfaction Scale, and Job Competency Assessment Scale. The mediating effect of occupational satisfaction on the relationship between occupational environment support and job competency of hospital infection prevention and control personnel was analyzed. Results A total of 1027 hospital infection prevention and control personnel from 728 medical institutions participated in this survey, with 989 valid questionnaires and an effective response rate of 96.3%. There were statistically significant differences in the job competency scores of hospital infection prevention and control personnel based on gender, years of experience in infection control work, professional background, highest education level, professional title, job nature, type of medical institution, and annual income (P<0.05). The total score of job competence for hospital infection prevention and control personnel was 301.0 (267.5, 326.0), the total score of occupational environment support was 21.44±3.66, and the total score of occupational satisfaction was 19.25±2.78. The occupational environment support of hospital infection prevention and control personnel was positively correlated with occupational satisfaction and job competence (r=0.373, 0.339; P<0.001), and occupational satisfaction was positively correlated with occupational environment support (r=0.547, P<0.001). The mediating effect of job satisfaction on the occupational environment support and job competence was 0.085, accounting for 22.8% of the total effect. Conclusion Occupational satisfaction partially mediates the relationship between occupational environment support and job competence, and the mediating effect is significant.
Objective To explore the independent risk factors for hospital infections in tertiary hospitals in Gansu Province, and establish and validate a prediction model. Methods A total of 690 patients hospitalized with hospital infections in Gansu Provincial Hospital between January and December 2021 were selected as the infection group; matched with admission department and age at a 1∶1 ratio, 690 patients who were hospitalized during the same period without hospital infections were selected as the control group. The information including underlying diseases, endoscopic operations, blood transfusion and immunosuppressant use of the two groups were compared, the factors influencing hospital infections in hospitalized patients were analyzed through multiple logistic regression, and the logistic prediction model was established. Eighty percent of the data from Gansu Provincial Hospital were used as the training set of the model, and the remaining 20% were used as the test set for internal validation. Case data from other three hospitals in Gansu Province were used for external validation. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) were used to evaluate the model effectiveness. Results Multiple logistic regression analysis showed that endoscopic therapeutic manipulation [odds ratio (OR)=3.360, 95% confidence interval (CI) (2.496, 4.523)], indwelling catheter [OR=3.100, 95%CI (2.352, 4.085)], organ transplantation/artifact implantation [OR=3.133, 95%CI (1.780, 5.516)], blood or blood product transfusions [OR=3.412, 95%CI (2.626, 4.434)], glucocorticoids [OR=2.253, 95%CI (1.608, 3.157)], the number of underlying diseases [OR=1.197, 95%CI (1.068, 1.342)], and the number of surgical procedures performed during hospitalization [OR=1.221, 95%CI (1.096, 1.361)] were risk factors for hospital infections. The regression equation of the prediction model was: logit(P)=–2.208+1.212×endoscopic therapeutic operations+1.131×indwelling urinary catheters+1.142×organ transplantation/artifact implantation+1.227×transfusion of blood or blood products+0.812×glucocorticosteroids+0.180×number of underlying diseases+0.200×number of surgical procedures performed during the hospitalization. The internal validation set model had a sensitivity of 72.857%, a specificity of 77.206%, an accuracy of 76.692%, and an AUC value of 0.817. The external validation model had a sensitivity of 63.705%, a specificity of 70.934%, an accuracy of 68.669%, and an AUC value of 0.726. Conclusions Endoscopic treatment operation, indwelling catheter, organ transplantation/artifact implantation, blood or blood product transfusion, glucocorticoid, number of underlying diseases, and number of surgical cases during hospitalization are influencing factors of hospital infections. The model can effectively predict the occurrence of hospital infections and guide the clinic to take preventive measures to reduce the occurrence of hospital infections.
ObjectiveTo investigate the effects of nursing interventions on reducing the hospital infection rates in children with extremely low birth weight. MethodsA total of 158 children with extremely low birth weight were treated in our hospital from January 2012 to June 2013. Based on the routine care, we took a series of other nursing interventions, such as strengthening environmental management, strict materials management and disinfection, active prevention of ventilator-associated pneumonia and catheter-related bloodstream infections, close monitoring of a series of isolated neonatal care interventions, to reduce the nosocomial infections in these children. ResultsThe hospital infection rate of this group of children was 9.49%, and the rate of infection cases was 10.76%. The infection sites included blood system, respiratory tract, digestive tract, mouth and eye. The patients were improved or cured after anti-infection and symptomatic treatment and caring measures. ConclusionScientific nursing interventions can reduce the incidence of nosocomial infection in children with extremely low birth weight.
ObjectiveTo study the present situation of hospital orthopedic surgery incision infection, in order to provide the basis for further intervention. MethodsProspective investigation combined with retrospective investigation method was adopted in our study to perform a statistical analysis on orthopedic surgery incision infections among 545 patients in our hospital between January and December 2012. ResultsDuring the one year of follow-up, there were 10 cases of surgical incision infection among all the 545 patients, with an infection rate of 1.83%. The infection rate of class-Ⅰ incision was 0.46%, of class-Ⅱ was 5.13%, and of class-Ⅲ/Ⅳ was 12.12%, and the Cochrane-Armitage trend chi-square test showed significant trend among them (χ2=28.273, P<0.001). Based on different operation risk index, patients with index 1, 2, 3 had a surgical site infection rate of 0.82%, 2.60%, and 18.75%, respectively. The higher the index, the higher the surgery incision infection rate, and the trend was statistically significant (χ2=12.916, P<0.001). The infection rate was 1.43% for elective surgical procedures, and was 3.15% for emergency surgery, but there was no significant difference (P>0.05). ConclusionOrthopedic surgery has a high-risk surgical site infection rate, and incision classification and surgical risk index have statistical correlation with the incidence of hospital infection. In order to ensure the security of patients and reduce medical disputes, we should pay close attention to orthopedic surgery infection.
Objective To explore the effect of “net bottom” management in the control of device-associated infections (DAIs) in elderly patients by setting infection monitoring doctors and nurses in the emergency intensive care unit (EICU). Methods Elderly patients who aged≥60 years old admitted to the EICU of the First People’s Hospital of Lianyungang between April 2018 and March 2021 were selected as the research subjects. A “net bottom” management mode was established and implemented for the purpose of infection prevention and control, taking medical and other departments as the coordination and management subjects, and infection monitoring doctors and nurses as the core. The effectiveness of the management intervention was evaluated by comparing the incidences of DAIs in elderly patients, the compliance rates of medical staff in hand hygiene, and the consumption of hand sanitizer per bed day in EICU among the primary stage (from April 2018 to March 2019), intermediate stage (from April 2019 to March 2020), and later stage (from April 2020 to March 2021). Results During the primary stage, intermediate stage, and later stage, there were 540, 497, and 507 elderly inpatients in EICU monitored, respectively, and the incidences of nosocomial infections were 7.22% (39/540), 5.84% (29/497), and 4.14% (21/507), respectively, showing a decreasing trend (χ2trend=4.557, P=0.033). The incidences of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections decreased from 4.82‰, 2.53‰, and 0.95‰, respectively in the primary stage, to 0.51‰, 1.01‰, and 0.53‰, respectively in the later stage, among which the difference in the incidence of ventilator-associated pneumonia was statistically significant (P<0.05). The hand hygiene compliance rate of EICU medical staff increased from 70.39% to 86.67% (P<0.05), and the consumption of hand sanitizer per bed day increased from 33.70 mL to 67.27 mL. The quarterly hand hygiene compliance rate was positively correlated with the quarterly consumption of hand sanitizer per bed day (rs=0.846, P=0.001), and negatively correlated with the quarterly incidence of nosocomial infections (rs=–0.769, P=0.003). Conclusion The “net bottom” management by setting up infection monitoring doctors and nurses in the EICU and multi-department collaboration can reduce the incidence of DAIs in elderly patients in EICU, which plays a positive role in promoting the hospital infection management and improving the quality of hospital infection management.
The prevention and control of COVID-19 has entered a critical moment. “Disease control of 2019 novel coronavirus infection in hospital: West China urgent recommendation” based on the best available evidence and expert experience, provided emergency recommendations for key clinical issues in hospital prevention and control during the COVID-19 epidemic. This recommendation with strong reference value and timeliness is worth learning for hospital managers, sensory control personnel and medical staff at all levels. All medical institutions should establish an emergency response mechanism to accelerate the formation of medical teams and strengthen the protection of medical staff and hospital infection control. We should enhance the implementation of policy and reinforce risk assessment. It is essential to strengthen the implementation of various prevention and control measures as well as risk assessment so as to eventually win the battle of coronavirus infection as soon as possible.
In recent years, with the increasing attention of health administrative departments and medical institutions at all levels to hospital infection, the prevention and control of hospital infection is increasing. As an important part of the quality control network, the role of provincial quality control center has a very important impact on the effectiveness of quality control work. Since its establishment, “Gansu Provincial Medical Quality Control Center of Hospital Infection Management” has actively explored the quality control mode suitable for the provincial situation, continuously strengthened the basic hospital infection quality control work, and innovated the quality control forms, especially the special quality control activities of “Infection Prevention in Gansu Province” with the core content of “supervision, training and investigation” carried out in combination with the provincial situation, which has created a new quality control work mode of the provincial quality control center. It is recognized and promoted by the national counterparts, and playes a positive role in promoting the management of hospital infection in the whole province. This article expounds the supervision practice of “Infection Prevention in Gansu Province” from four aspects in detail.