ABSTRACT
Objective To understand the status of hand hygiene(HH)of health care workers(HCWs)in a tertiary hospital in Zhuhai.Methods HH compliance of doctors,nurses,and cleaners randomly selected from 15 clinical de-partments in the whole hospital was observed through concealed observation by medical interns in October-Novem-ber 2016.Results HH compliance rate and correct rate of clinical departments in the whole hospital were 33.44%(1 131/3 382)and 59.86%(677/1 131)respectively,there was a significant difference in the compliance rate of HH among different types of HCWs (χ2 ＝12.610,P＝0.002),HH compliance rate from high to low was nurses (35.85%),cleaners (32.28%),and doctors (29.50%).Of five HH moments,HCWs’HH compliance rate after patient’s body fluid exposure was the highest (69.74%),while after touching patient surroundings was the worst (25.03%).HH compliance rates of HCWs with different occupations at different HH moments were all significant-ly different (all P＜0.05),HH compliance rates of doctors before aseptic procedure and after patient’s body fluid exposure were higher than nurses(71.25% vs 32.44%;82.86% vs 69.78%,respectively),HH compliance rate of nurses was highest after touching a patient(40.06%).Conclusion HH status in this hospital is not optimistic,HH compliance rate and correct rate are low,HH compliance rates of HCWs with different occupations and at different HH moments are both different,which need to be improved.
ABSTRACT
Objective To investigate hand hygiene status of health care workers (HCWs)in a hospital,and pro-vide guides for improving hand hygiene compliance.Methods Hand hygiene intervention was adopted in a hospital between 2012 and 2014,hand hygiene compliance among HCWs and healthcare-associated infection in patients be-tween August 1 and August 31 of each year were investigated and analyzed statistically.Results In 2102 -2014, hand hygiene compliance rate of HCWs was 59.55%,62.13%,and 65.16% respectively,which showed a increased trend (χ2 =10.018,P =0.002),HAI rate was 2.13%,1 .48% and 1 .06% respectively,which showed a decreased trend (χ2 =82.377,P <0.001 );hand hygiene compliance rate of doctors was lower than nurses (57.97% vs 65.97%);Of different hand hygiene moments,hand hygiene compliance rate was the lowest before touching a pa-tient(41 .32%),and highest after body fluid exposure (76.47%).Conclusion Comprehensive hand hygiene inter-vention in this hospital has achieved preliminary results,improvement of HCWs’hand compliance is helpful for pre-venting HAI.
ABSTRACT
Objective To explore the clinical significance of procalcitonin(PCT)in guiding the optimizing antimi-crobial treatment strategy in ventilator-associated pneumonia(VAP).Methods Sixty patients receiving mechanism ventilation for ≥48 hours in an intensive care unit between November 2011 and April 2013 were randomly divided into control group (n=29)and trail group (n=31),patients in control group stopped antimicrobial use according to guideline,patients in trail group stopped antimicrobial use according to serum procalcitonin level,duration of anti-microbial use and mechanical ventilation between two groups were compared.Results Days of mechanical ventila-tion,length of ICU stay,mortality rates between two groups were not significantly different(all P >0.05);antimi-crobial days in trail group was significantly less than control group([10.70 ±3.78]d vs [13.93 ±3.03 ]d)(t =4.484;P <0.001).Conclusion Serum procalcitonin level plays an important role in the rational use of antimicrobial agents in patient with VAP.
ABSTRACT
Objective To evaluate risk factors for multidrug-resistant Acinetobacter baumannii (MDRAB)infec-tion,so as to provide reference for making preventive and control measures of MDRAB infection.Methods Clinical data of patients with Acinetobacter baumannii (A.baumannii )infection in a hospital between April 2011 and Sep-tember 2012 were surveyed,distribution and specimen sources of A.baumannii and MDRAB were analyzed,and risk factors of MDRAB were assessed.Results Of 236 isolates of A.baumannii,74 (31.36%)were MDRAB .The isolation rate of MDRAB in intensive care unit and neurosurgery department was up to 60.00%(27/45)and 58.06%(18/31)respectively;MDRAB were mainly isolated from wound (45.45%),respiratory tract (34.27%),and urinary tract (17.65%).Univariate analysis revealed that difference in length of hospital stay,use of serum albumin,fiberbronchoscopy, coma days,tracheotomy,use of ventilator,incisional drainage,urinary catheterization,use of carbapenems,and antimicro-bial days in different groups were statistically different (P <0.05).Multivariate logistic regression analysis revealed that tracheotomy(OR95%CI :1.152-7.187),use of ventilator(OR95%CI :1.263 -7.664)were independent risk factors for MDRAB infection.Conclusion Tracheotomy and use of ventilator play an important role in the producing and sprea-ding of MDRAB ,management on drug-resistant bacteria is important in reducing MDRAB infection.