Practice and exploration of capacity building for infection control practitioners / 中华医院管理杂志

Infection prevention and control(hereinafter referred to as " infection control" )practitioners are the backbone of infection control teams of individual departments. Their capacity-building is key to improving the management efficiency at both hospital and department levels, which can effectively ensure medical safety. Since 2017, a tertiary traditional Chinese medicine hospital had scored desirable results based on the analysis of the problems existing in their capacity-building. In its explorations, the hospital attempted to improve the professional competency and management ability by the following measures. These measures included improving and standardizing the organization and management, establishing an on-the-job training system, formulating an annual management manual of department′s infection control teams, implementing a cross inspection system and patrol system of the practitioners during an epidemic, establishing an assessment and evaluation system and incentive mechanism, establishing infection control elite teams, and building a mode dominated by infection control doctors. These experiences can provide reference for optimizing the capacity building of the infection control practitioners.

Hand hygiene cognition among healthcare-associated infection management staff in Gansu Province / 中国感染控制杂志

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.

Application of transparent supervision in the multidrug-resistant organism management / 中华医院管理杂志

Objective@#To explore the practice and effect of transparent supervision in the prevention and control of multidrug-resistant organism (MDRO).@*Methods@#Transparent supervision was introduced to intervene into the MDRO management of monitored departments. Such transparent supervision was aided by IT means, and transparent MDRO control indexes. These indexes included hand hygiene compliance rate, qualification rate of ATP detection of environmental object surface, implementation rate of main MDRO prevention and control measures, MDRO resistance rate, and nosocomial infection incidence. The data before and after the intervention were compared by Chi square test to evaluation the effect.@*Results@#After intervention, the hand hygiene compliance rate increased from 49.83% to 65.61% (χ2=47.389, P<0.001), and the qualification rate of ATP detection of environmental object surface increased from 48.50% to 83.33% (χ2=96.115, P<0.001). Meanwhile, such indexes as prescription of patient isolation, placement of isolation identifiers and that of specialized bedside equipments increased significantly(P<0.001). The MDRO detection rate decreased from 75.08% to 63.31% (χ2=28.123, P<0.001), and the incidence of nosocomial infection decreased from 4.77% to 3.47%(χ2=20.303, P<0.001).@*Conclusions@#The practice of transparent supervision could reduce the risk of MDRO transmission at hospitals effectively, proving its importance in ensuring medical quality and patient safety.

Application of PDCA cycle in the hospital management of multidrug-resistant organisms / 中国感染控制杂志

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.

Infection management at 101 medical institutions in Xinjiang from 1995 to 2015:review and analysis / 中华医院管理杂志

Objective To analyze the changes in the organizational development and operations of infection management in Xinjiang in the past 20 years, and to explore optimal approaches for infection control in the region. Methods Stratified random sampling method was used for the survey of the infection management at 101 medical institutions of 12 prefectures in Xinjiang from 1995 to 2015. The survey covered the organization construction, staffing, and infection control work of these hospitals. Results The infection rate of hospitals in the northern part was higher than that of the southern part; the average beds of the hospitals increased from 169. 96 to 428. 27. Organization system of hospital infection management was gradually established and improved;Personnel makeup becomed more reasonable, yet greater manpower was needed for full-time staff; The operations and patterns of hospital infection management work had evolved from a few to the multidimensional; There are rooms for elevation in research of hospital infection. Conclusions The past 20 years have witnessed major progress of infection management in Xinjiang, but sustainable development in this regard calls for optimized staffing structure and better research ability.

Role of infection control nurses in healthcare-associated infection management / 中国感染控制杂志

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.

Infection management at 101 medical institutions in Xinjiang from 1995 to 2015:review and analysis / 中华医院管理杂志

Objective To analyze the changes in the organizational development and operations of infection management in Xinjiang in the past 20 years, and to explore optimal approaches for infection control in the region. Methods Stratified random sampling method was used for the survey of the infection management at 101 medical institutions of 12 prefectures in Xinjiang from 1995 to 2015. The survey covered the organization construction, staffing, and infection control work of these hospitals. Results The infection rate of hospitals in the northern part was higher than that of the southern part; the average beds of the hospitals increased from 169. 96 to 428. 27. Organization system of hospital infection management was gradually established and improved;Personnel makeup becomed more reasonable, yet greater manpower was needed for full-time staff; The operations and patterns of hospital infection management work had evolved from a few to the multidimensional; There are rooms for elevation in research of hospital infection. Conclusions The past 20 years have witnessed major progress of infection management in Xinjiang, but sustainable development in this regard calls for optimized staffing structure and better research ability.

Role of infection control nurses in healthcare-associated infection management / 中国感染控制杂志

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.

Survey on occupational exposure among medical laboratorians / 中国感染控制杂志

Objective To understand the occupational exposure among medical laboratorians in a hospital,and put forward prevention and control measures.Methods Occupational exposure among medical laboratorians in the department of laboratory medicine of a hospital from January 2011 to December 2014 were analyzed statistically.Results A total of 72 cases of occupational exposure occurred among 217 laboratorians during 4 years,occupational exposure rate was 33.18％,the occupational exposure rate in interns was 46.23％,and in laboratorians with working seniority＜ 1 years was 49.56％.Occupational exposure mainly occurred in outpatient blood collection room(accounting for 38.89 ％),the main occupational exposure types were injuries by blood collection needles,skin contaminated by blood and body fluid(76.39 ％).Occupational exposure rates in medical laboratorians in this hospital during 2011-2014 were 53.66％(22/41),41.67％(20/48),26.23％(16/61),and 20.90％(14/67),respectively,which presented a declining tendency(x2 =12.286,P＜0.01).After occupational exposure,only 23 cases were reported according to the requirements of infection management department,the missing report rate was 68.06％ (49/72),correct handling rate was 80.56％ (58/72).Conclusion Laboratorians should strengthen education and training of healthcare-associated infection management,improve safety and prevention consciousness,standardize handling process,improve consciousness of reporting,so as to reduce the occurrence of occupational exposure and post exposure infection.

Status of healthcare-associated infection management professionals in 85 traditional Chinese medicine institutions / 中国感染控制杂志

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.

Practice and consideration of fostering hospital execution culture for healthcare-associated infection management / 中国感染控制杂志

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.

Development situation of healthcare-associated infection management de-partments in the rational antimicrobial application and management in China / 中国感染控制杂志

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.

Development situation of healthcare-associated infection management organizations in Xinjiang region / 中国感染控制杂志

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.

Development of healthcare-associated infection management organizations in China in the past 30 years / 中国感染控制杂志

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.

Cost of healthcare-associated infection management in a tertiary first-class hospital / 中国感染控制杂志

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.

Application of quality control circle in hospital infection control / 中华医学教育探索杂志

To investigate and step in the compliance of clinician hand hygiene, we used vari-ous management tools of the quality control circle (QCC), and then compared the change of the com-pliance before and after any operations. Firstly, we followed this 5 steps: selecting themes, drafting plans, grasping current situations, setting goals and analyzing objectives. Then, we formulated and im-plemented the interventions pertinently. All of the QCC members participated actively in the whole process. The compliance of clinician hand hygiene was improved from 41.11%to 57.59%. The realiza-tion rate was 115.97%, the progress rate was 40.99%, and the hand hygiene compliance of hand hy-giene in different time was significantly improved with the average value 1.25. Standardized result formed by quality control circle activity had a comprehensive promotion in the hospital and promoted the management of hospital infection and the development of hospital.

The Bacteriology of Discharging Ear (Otitis Media) Amongst Children in Owerri, Imo State, South East Nigeria.

The prevalence of causative agents of acute otitis media amongst children in some parts of Owerri, Imo State - Nigeria was investigated, between the months of September and December, 2012 using standard microbiological methods. One hundred and fifty two swabs from ear discharge were collected from children under 12 years of age. The results revealed that 128 (84.2%) were positive for bacterial growth while 24 (15.8%) had no growth. The predominant organisms isolated included Pseudomonas aeruginosa (37.5%), Staphylococcus aureus (23.4%), Proteus species (12.5%), Klebsiella pneumoniae (7.8%), Escherichia coli (7.8%) and Streptococcus pneumoniae (7.8%). Antibiotic susceptibility tests revealed that all the isolates were multiresistant to six or more of the tested antibiotics while the most prevalent organisms were susceptible to gentamycin, chloramphenicol and cotrimoxazole. Pseudomonas aeruginosa and Proteus mirabilis were susceptible to ofloxacin and ciprofloxacin. All the isolates were resistant to amoxicilline/clavulanate spectinomycin and ofloxacin (except Staphylococcus aureus). Therefore, chloramphenicol, gentamycin, cotrimoxazole ciprofloxacin and ofloxacin, are suggested as topical treatment in the management of acute otitis media and good personal hygiene is also encouraged.

Hospital administrators’recognition extent to healthcare-associated infec-tion management staff ’s competency and qualification / 中国感染控制杂志

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.

Effect analysis of intervention strategies used in infection control in 21 hospitals / 中华医院管理杂志

Objective To search for intervention strategies for upgrading existing infection control in hospitals. Methods Intervention measures include training, field study and practice guidance, as well as process evaluation and workshops, which help promote infection control in target hospitals. Results With the intervention measures called into play, the exam score of hospital leaders in hospital infection control rose from 61.6 to 71. 3 (P＜0. 05), and that of hospital care workers'(HCW) and of infection control staff's rose as well (from 65. 53 to 78. 78, and from 58. 58 to 85. 48, respectively) (P＜0. 001);the percentage of full-time staff for infection control rose from 61. 3% to 87. 5%, and the hospitals with an infection control committee rose from 15 to 20 hospitals; while the hospitals having a well-functioning infection control committee rose from 71. 4% to 95. 2%. The times of training received by HCW rose significantly (2. 2 to 3. 6 times). The average scores for the quality of infection control increased from 79. 79 to 92.43 step by step. Conclusion The general intervention in hospital infection control takes the efforts of all departments in the hospital.

Medical waste management in the hospital / 中华医院管理杂志

Enhanced management of the entire process of medical wastes, ranging from sorting collection, delivery, transport to temporary storage: compilation of the computerized management system for medical wastes: development of quality control inspection standards for medical wastes: all-staff training for the awareness of legal compliance for medical wastes, prevention of medical wastes from jeopardizing both human being and the environment.