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Objective To understand the cognition and influencing factors of hand hygiene (HH) among healthcare-associated infection (HAI) management staff in Gansu Province, and provide reference for enhancing the special competency of HAI management staff.Methods According to geographical area, natural and human characteristics, HAI management staff in 69 hospitals in different areas of Gansu Province were selected to conduct a questionnaire and field survey on their basic condition and knowledge of HH, current situation, and influencing factors for HH knowledge were analyzed.Results Among 69 surveyed hospitals, 82.61％ were secondary hospitals, 17.39％ were tertiary hospitals;among 125 surveyed HAI management staff, 82.40％ were full-time staff and 17.60％ were parttime staff.33.60％ and 66.40％ of HAI management staff had complete and incomplete knowledge of HH respectively;the knowledge about importance of HH, use of hand disinfectant, installation of HH facilities, hand washing methods, hand drying methods, HH indications, and standard for judging qualified HH in tertiary hospitals were all higher than those in secondary hospitals (all P＜0.05).Multivariate logistic regression analysis showed that independent protective factors for HH cognition were working for≥5 years and＜10 years in HH management (OR=3.067), bachelor's degree (OR=3.331), and full-time job (OR=10.309).Conclusion HAI management staff's cognition on HH among is low, especially those who have been engaged in HH management for less than 5 years, whose educational background is secondary school or lower, and part-time personnel.It is necessary to combine with actual condition to strengthen professional competence training for HH management staff.
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Objective To analyze the change in isolation rates of multidrug-resistant organisms (MDROs) before and after adopting plan-do-check-act (PDCA) cycle method for management of MDROs. Methods Bacterial culture specimen submission and isolation of MDROs in a tertiary first-class hospital before the implementation of PDCA cycle (January 2013-December 2014) and after implementation of PDCA cycle (January 2015-December 2016) were collected and analyzed. Results A total of 14 889 specimens were sent for detection before the implementation of PDCA cycle, 6 345 strains were isolated, 650 of which were MDROs, isolation rate of MDROs was 10. 24％; after the implementation of PDCA cycle, 17 856 specimens were sent for detection, 7 568 strains were isolated, 476 were MDROs, isolation rate of MDROs was 6.29％; difference in MDRO detection rate before and after the implementation of PDCA was statistically significant (X2=72.567, P＜0.001). After Cochran-Armitage trend test, the isolation rates of MDROs in 2013-2016 showed a decreased trend (Z= - 7.8856). The amount and cost of hand hygiene products have increased. Conclusion By carrying out PDCA cycle for MDROs management, the isolation rate of MDROs in hospital is reduced. PDCA cycle management method can effectively promote the continuous quality improvement of hospital MDROs management.
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Objective To explore the role of infection control nurses in healthcare-associated infection(HAI)man-agement,and provide basis for HAI management.Methods Through setting up infection control nurses in clinical departments of the whole hospital,clarifying their responsibilities and duties,training,and supervising them,the effect of infection control nurses on HAI management was observed.Results A total of 67 infection control nurses were set up in the clinical departments of the whole hospital,HAI management knowledge among health care work-ers (HCWs)in 26 departments improved significantly,scores of HAI management knowledge among HCWs in April and December was compared,difference was statistically significant (Z = - 2.193,unilateral P = 0.014). Hand hygiene compliance rate of HCWs improved from 83.35%(1817/2180)in April to 89.53% (2002/2236)in December,difference was statistically significant(χ2 =36.13,P <0.01).A total of 56670 hospitalized patients were monitored from April to December 2015,the total length of hospital stay was 411164 days,utilization rate of three catheters was 27.18%,three catheter-related infection rate was 0.74‰.The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September(P <0.05).Conclusion Setting up infection control nurses is of great significance to strengthen the HAI management organization and pro-mote the quality of HAI management.
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Objective To explore the role of infection control nurses in healthcare-associated infection(HAI)man-agement,and provide basis for HAI management.Methods Through setting up infection control nurses in clinical departments of the whole hospital,clarifying their responsibilities and duties,training,and supervising them,the effect of infection control nurses on HAI management was observed.Results A total of 67 infection control nurses were set up in the clinical departments of the whole hospital,HAI management knowledge among health care work-ers (HCWs)in 26 departments improved significantly,scores of HAI management knowledge among HCWs in April and December was compared,difference was statistically significant (Z = - 2.193,unilateral P = 0.014). Hand hygiene compliance rate of HCWs improved from 83.35%(1817/2180)in April to 89.53% (2002/2236)in December,difference was statistically significant(χ2 =36.13,P <0.01).A total of 56670 hospitalized patients were monitored from April to December 2015,the total length of hospital stay was 411164 days,utilization rate of three catheters was 27.18%,three catheter-related infection rate was 0.74‰.The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September(P <0.05).Conclusion Setting up infection control nurses is of great significance to strengthen the HAI management organization and pro-mote the quality of HAI management.
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Objective To investigate the current status of healthcare-associated infection(HAI) management professionals in county and above levels of traditional Chinese medicine(TCM) institutions in a province.Methods The uniform questionnaires were adopted to investigate the basic status of HAI professionals in county and above levels of TCM institutions in a province.Results There were 117 county and above levels of TCM institutions in this province,85 TCM institutions participated the investigation,there were a total of 128 professionals,including 82 professionals in 65 secondary hospitals,and 46 in 20 tertiary hospitals.Among the investigated TCM hospitals,83 (97.65 ％) set up HAI management committees,77 (90.59％) set up independent HAI management departments,55 (64.71％) assigned HAI professionals that met The Requirements of HAI Surveillance Guideline,27 (31.76 ％) exclusively engaged in management of HAI,58 (68.24 ％) were also responsible for other management besides HAI management.Among investigated professionals,91.41％ were nursing staff,55.47％ received undergraduate course or above,54.69％ had intermediate professional titles,61.72％ were at the age of 41-50,45.31 ％ engaged in HAI management for 1-3 years,115 professionals had management certificates.Conclusion The infec tion management in provincial traditional Chinese medicine institutions are understaffed,professional structure is unitary,professional quality is low,leaders in different levels of TCM institutions should enhance HAI management awareness,strengthen the construction of professional quality,and cultivate multi-disciplinary talents as soon as possible.
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Objective To understand the development situation of healthcare-associated infection (HAI)manage-ment departments in the rational antimicrobial application and management in hospitals in China.Methods A total of 166 hospitals from 12 provinces,municipalities,autonomous regions,and military hospitals were selected for survey,the participation of HAI management departments in the rational clinical antimicrobial application and man-agement in different years was compared.Results Of 166 hospitals,68(40.96%)in 2005,119(71.69%)in 2010, and 160(96.39%)in 2015 participated in the establishment of management organizations for rational antimicrobial application (χ2 =121.143,P <0.001).The percentage of HAI management departments participating in antimicro-bial management increased from 10.24%(n=17)in 2005 to 22.29%(n=37)in 2010,and 31.33%(n=52)in 2015 (χ2 =22.172,P < 0.001 ).The percentages of HAI management departments participating in formulating cata-logues for antimicrobial varieties and classification,stipulating permission for antimicrobial use,joining antimicrobi-al management teams,monitoring bacterial resistance,managing antimicrobial prophylaxis in clean incision,super-vising clinical antimicrobial use,conducting clinical consultation,and evaluating prescription were 10.87% -30.72% in 2005,25.90%-65.06% in 2010,and 36.14%-95.18% in 2015 (all P <0.01).Intensity of antimicro-bial use (defined daily dose/100 bed-days,DDD/ 100 bed-days)decreased from 69.16 in 2005 to 41.40 in 2015, antimicrobial usage rate decreased from 46.98% in 2005 to 36.90% in 2015,among patients receiving therapeutic antimicrobial use,specimens sending for pathogenic detection increased from 20.58% in 2005 to 49.39% in 2015. Conclusion Departments of HAI management in China play important role in management of rational antimicrobial application.
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Objective To understand the development status of healthcare-associated infection (HAI)management organizations in Xinjiang region,and effectively improve the management level of HAI in Xinjiang.Methods 101 secondary and above medical institutions in Xinjiang were selected by cluster random sampling method,a retrospec-tive survey was conducted from February 15 to March 31,2016.Development of HAI management organizations in each hospital in 1995,2000,2005,2010,and 2015 were surveyed,statistical analysis of the surveyed results were conducted.Results Of 101 hospitals,22 were tertiary hospitals,79 were secondary hospitals.In 2005 and before, more than 70% of hospitals with >300 beds and 20% of hospitals with300 beds and less than 5% of hospitals with 50% of full-time professionals received secondary vocational school and below education,in 2005 and after,about 80% of full-time professionals received at least college and above education;in 2000 and before,> 70% of full-time professionals didn’t receive training.In 2015,the percentage of nursing staff engaged in HAI management dropped to 65.90%,and doctors and other professionals both accounted for 17.05%,40.09% of HAI management professionals received university education,92.08% par-ticipated in autonomous region level and above training,1.98% didn’t receive training.Conclusion HAI infection management organizations in Xinjiang region in the past 20 years have developed,the allocation of professionals and professional quality can not meet the needs of HAI infection management in this region.
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Objective To understand the development of healthcare-associated infection(HAI)management organ-izations in China in the past 30 years.Methods Development of HAI management organizations in 12 provinces (municipalities,autonomous regions)in China was surveyed.Results A total of 166 hospitals were surveyed,96 (57.83%)were tertiary hospitals.Among 164 hospitals which had a history of development of HAI management department,46(28.05%)before 1995,63(38.14%)in 1995-2005,and 55(33.54%)in 2005-2015 set up HAI management departments.HAI management professionals per 1 000 beds in 165 hospitals decreased from 4.80 in 1995 to 4.09 in 2015,occupational categories in HAI management departments in 1995 -2015 were significantly different (χ2 =26.22,P <0.01).The constituent ratios of education background and profession of HAI manage-ment professionals in each province in 1995-2015 were significantly different(χ2 =242.91,47.10,respectively,all P <0.01).In 1995 and 2005,70.81%,53.30% of professionals were with college degree or below;in 2015,the percentage of professionals with bachelor’s degree,doctoral degree,and master’s degree were 53.79%,2.45%, and 22.86% respectively.Most professionals were nursing staff,but the percentage decreased from 58.38% in 1995 to 45.96% in 2015.Conclusion Although HAI management organizations have developed for 30 years and made some achievements,there still remain some problems,the proportion of professionals needs to be enhanced,and personnel structure should be optimized.
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Objective To explore the application value of hospital execution culture in healthcare-associated infec-tion(HAI)management.Methods All departments in a hospital from January 1 ,2013 to December 31 ,2014 were studied.From January 1 ,2014,ideas and fostering methods for hospital execution culture were applied in HAI management,the working enthusiasm,working ability,and working achievements of health care workers (HCWs) on HAI control before and after the application of execution culture were compared.Results 53 departments in the hospital were surveyed annually in 2013 and 2014.Working enthusiasm:the number of departments participating in hospital-wide training increased from 24 (45.28%)to 49 (92.45%),the number of departments that carried out subsequent training increased from 21(39.62%)to 48(90.57%),departments that initiatively carried out self-inspec-tion increased from 10(18.87%)to 43(81 .13%),differences were all significant (all P <0.001).Working ability:percentage of HCWs knew knowledge about hand hygiene as well as prevention and control measures for multidrug resistance bacteria increased from 49.05% (103/210)and 37.14% (78/210)to 96.30% (208/216)and 97.22%(210/216)respectively;while in 2013,only 2 departments (3.77%)performed regular rectification on daily work, which increased to 19 departments (35.85%)after training,differences were all significant (all P <0.001).Working achievements:the qualified rate of correct hand hygiene among HCWs increased from 8.57%(18/210)to 87.04%(188/216);implementation rate of multidrug resistance bacteria isolation increased from 50.00% to 80.08%,path-ogenic detection in patients receiving therapeutic antimicrobial agents increased from 28.85% to 51 .30%,differ-ences were all significant(all P <0.001).Conclusion Fostering of hospital execution culture has improved the en-thusiasm and work ability of HCWs to participate in HAI management,promoted the implementation of HAI man-agement,and is a powerful tool for the management of HAI.
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Objective To explore the cost of healthcare-associated infection (HAI)management in a tertiary first-class hospital,provide data support for cost-effectiveness and cost-benefit analysis of HAI management,and provide scientific evidence for the rational allocation of hospital resources.Methods Micro-costing study was used to calcu-late the direct cost of the department of HAI management by collecting the quantity and unit price of each item. Results The total cost of HAI management in this hospital in 2013 were about ￥870 000,including human cost￥790 000,depreciated fixed assets ￥34 501 ,low-value consumption goods ￥3 800,publicity and training￥33 600,office consumables ￥5 208;average cost were ￥12.16 per person and ￥529.69 per bed.Conclusion Human cost is the main cost in HAI management in this hospital.
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Objective To realize hospital administrators ’recognition extent to healthcare-associated infection (HAI )management staff ’s competency and qualification.Methods The unified questionnaires were filled in by respondents in 173 hospitals of Inner Mongolia autonomous Region,administrators’recognition on the competency and qualification of HAI management staff were surveyed.Results Of 445 hospital administrators,20.09%, 19.89%,and 18.05% considered that staff members in HAI management departments should have the knowledge background of preventive medicine,clinical medicine,and nursing respectively.58.20%,89.44%,and 43.37% of hospital administrators considered that the directors of HAI management departments should have senior profession-al titles,undergraduate course or above,and with 2 -5 working experience,respectively.34.92% and 30.93%considered that the most important professional ability of directors of HAI management department were profession-al and management ability,respectively.Conclusion Hospital administrators are apt to consider that the competen-cy and qualification of HAI management staff are strong professional ability and certain management ability,and are interdisciplinary talents.