4R危机管理对多重耐药菌感染防控措施落实情况及感染发生率的影响

中华养生保健 ›› 2024, Vol. 42 ›› Issue (17): 89-91.

4R危机管理对多重耐药菌感染防控措施落实情况及感染发生率的影响

谢秀璋

江苏大学附属武进医院/徐州医科大学武进临床学院医院感染管理科,江苏常州,213000

出版日期:2024-09-01 发布日期:2024-08-21
作者简介:谢秀璋（1972—）,女,汉族,籍贯：江苏省常州市,本科,副主任护师,研究方向：多重耐药菌感染防控。

The Impact of 4R Crisis Management on the Implementation of Prevention and Control Measures for Multidrug-Resistant Bacterial Infections and the Incidence of Infection

XIE Xiu-zhang

Department of Nosocomial Infection Management, Wujin Hospital Affiliated to Jiangsu University/Wujin Clinical College of Xuzhou Medical University, Changzhou Jiangsu 213000, China

Online:2024-09-01 Published:2024-08-21

摘要/Abstract

摘要： 目的探究4R危机管理对多重耐药菌感染防控措施落实情况及感染发生率的影响。方法选取2020年4月—2023年4月江苏大学附属武进医院的370名医务人员作为研究对象，根据管理方案不同分为两组，对照组（n=180）接受常规多重耐药菌相关培训，研究组（n=190）在对照组基础上增加4R危机管理，对比干预前后两组多重耐药菌感染防控措施知晓情况、手卫生依从性情况及多重耐药菌感染发生情况。结果干预前两组医务人员多重耐药菌感染防控知识掌握情况比较，组间差异无统计学意义（P>0.05）；干预后研究组医务人员知识掌握情况高于对照组（P<0.05）。研究组不同岗位医务人员手卫生依从性均高于对照组，组间差异具有统计学意义（P<0.05）。干预前两组多重耐药菌感染发生率比较，差异无统计学意义（P>0.05）；干预后研究组多重耐药菌感染发生率低于对照组，差异有统计学意义（P<0.05）。结论 4R危机管理模式在提高医务工作者多重耐药菌感染防控措施落实程度方面价值肯定，可以显著降低患者体液多重耐药菌检出率，具有较好的应用价值。

关键词: 4R危机管理模式, 多重耐药菌感染, 防控措施, 医院感染率

Abstract: Objective To explore the impact of 4R crisis management on the implementation of prevention and control measures for multidrug-resistant bacterial infections and the incidence of infections. Methods A total of 370 medical workers from Wujin Hospital affiliated to Jiangsu University from April 2020 to April 2023 were selected as the study subjects and divided into two groups according to different management plans. 180 control group received routine training on multidrug-resistant bacteria, and 190 study group received 4R crisis management on the basis of the control group. Before and after the intervention, the knowledge and implementation of the prevention and control measures of multi-drug-resistant bacteria, hand hygiene and multi-drug-resistant bacteria infection in different samples were compared between the two groups. Results There was no significant difference in the knowledge of prevention and control of multidrug-resistant bacteria in the two groups before intervention (P>0.05). After intervention, the knowledge of medical staff in the study group was higher than that in the control group (P<0.05). The hand hygiene compliance of medical staff in different positions in the study group was higher than that in the control group (P<0.05). There was no difference in the incidence of multidrug-resistant bacteria infection between the two groups before intervention (P>0.05). After intervention, the incidence of multidrug-resistant bacteria infection in the study group (3.60%) was lower than that in the control group (8.40%) (P<0.05). Conclusion The 4R crisis management model has positive value in improving the implementation of prevention and control measures for multidrug-resistant bacterial infections among medical workers. It can reduce the detection rate of multidrug-resistant bacteria in patient fluids. It has good promotion and application value.

Key words: 4R crisis management mode, infection with multidrug-resistant bacteria, prevention and control measures, hospital infection rate

中图分类号:

R197.323

谢秀璋. 4R危机管理对多重耐药菌感染防控措施落实情况及感染发生率的影响[J]. 中华养生保健, 2024, 42(17): 89-91.

XIE Xiu-zhang. The Impact of 4R Crisis Management on the Implementation of Prevention and Control Measures for Multidrug-Resistant Bacterial Infections and the Incidence of Infection[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(17): 89-91.

参考文献

[1] 乔甫,黄文治,宗志勇.多重耐药菌感染防控的意义与发展趋势[J].中国护理管理,2019,19(8):1129-1134.
[2] 娃司玛·夏米力,夏木西卡玛尔·阿克木,邵丽,等.新疆地区三级医院多重耐药菌感染及耐药性分析[J].现代生物医学进展,2020,20(10):1881-1884.
[3] 桑玉还,严忠婷,袁媛,等.重症监护病房患者多重耐药菌感染风险预测模型的系统评价[J].中国感染控制杂志,2023,22(4):442-450.
[4] 陈玉,张朝辉,樊发超.应用主动筛查预防与控制重症监护病房患者多重耐药菌感染[J].中国感染控制杂志,2022,21(2):190-195.
[5] 毛筱俊,雷永良,叶石玄宝,等.医护一体妇幼专科医院感染预防联合跟班督导在降低婴幼儿多重耐药菌感染率中的临床应用研究[J].中国妇幼保健,2020,35(12):2252-2254.
[6] 卫生部. 多重耐药菌医院感染预防与控制技术指南(试行)[J].药物不良反应杂志,2011,13(2):108-109.
[7] 李六亿,赵艳春,贾建侠,等. 医务人员手卫生依从性的调查与分析[C] //第十五届全国医院感染管理学术年会论文集. 2008:343-345.
[8] 刘更新,曹素芬,闻静. 医院感染预防与控制[J]. 中国高等医学教育,2007(9):95,封3.
[9] 卜春红,滑立伟,付强,等.ICU呼吸机相关性肺炎病原菌分布情况及多重耐药菌感染的危险因素调查研究[J].河北医学,2022,28(7):1166-1172.
[10] 刘延一,杨俊华,叶丹.慢性阻塞性肺病急性加重患者呼吸道多重耐药菌感染危险因素分析[J].临床肺科杂志,2019,24(4):661-664.
[11] 梁艳芳,赖晓全,王坚苗,等.多学科协作模式在多重耐药菌感染管理中的应用研究[J].中国社会医学杂志,2019,36(4):402-406.
[12] 孙睿,陈丽萍,肖亚雄,等.多学科协作管理模式在多重耐药菌管理工作中的实践及持续改进效果分析[J].华西医学,2019,34(3):256-261.
[13] 杨晋如,刘丹,谈宜斌,等.重症医学科多重耐药菌感染风险因素的网状路径分析[J].中国感染控制杂志,2020,19(2):148-154.
[14] 陈国建,杨洁,邓艾,等.某综合医院常见多重耐药菌感染危险因素logistic回归分析[J].华西医学,2020,35(3):290-295.
[15] 刘淑正,杨立娜.基于4R危机管理与多学科协作理论的监护室多重耐药院内感染防控效果观察[J].护理学报,2020,27(7):30-33.