重症监护病房医院感染目标性监测分析及护理对策

    Target monitoring analysis and nursing measures of hospital infection in Intensive Care Unit

    • 摘要: 目的: 了解重症监护病房(ICU)患者医院感染的发生率和危险因素,并探讨相应的护理对策。方法: 按照WS/T312-2009行业标准《医院感染监测规范》,对2009年8月至2010年3月ICU住院患者进行目标性监测,分析发生医院感染的相关危险因素。结果: ICU住院> 48 h的100例患者中,发生医院感染22例,医院感染发生率为22.00%,40例次,例次感染发生率为40.00%,平均病情严重程度调整后医院感染发生率为11.7%;尿道插管使用率为59.67%,呼吸机使用率为37.66%,静脉插管使用率为58.22%;泌尿道插管相关泌尿道感染发生率为6.28‰,血管导管相关血流感染发生率为1.61‰,呼吸机相关肺炎感染发生率为24.87‰。检出病原菌49株,主要为革兰阴性杆菌(71.43%),且多重耐药。结论: ICU医院感染发生率明显高于其他科室,器械使用率以尿道插管最高,器械相关感染发生率以呼吸机相关肺炎感染发生率最高,医院感染病原菌以革兰阴性杆菌为主,且呈现多重耐药。加强防控措施,切断感染途径,做好基础及专科护理,可有效降低医院感染的发生。

       

      Abstract: Objective: To investigate the infection rate and risk factors of patients in Intensive Care Unit(ICU),and explore the corresponding nursing measures. Methods: According to the WS/T312-2009 professional standards-Hospital Infection Monitoring Standards,the ICU patients who hospitalized during the period of Aug. 2009 to Mar. 2010 were under target monitoring,and the related risk factors of hospital infection were analyzed. Results: Among the 100 ICU patients who had been in hospital for more than 48 hours, 22 cases were shown hospital infection,with a rate of 22.00%. While 40 cases with an infection rate of 40.00% were shown hospital infection of 11.7% after the regulation of the average severity of illness. The use rate of urethral catheter,ventilator and venous cannula were 59.67%,37.66% and 58.22%,respectively. Meanwhile,the urinary tract infection rate related to urethral catheter was 6.28‰, the blood flow infection rate related to blood vessel canals was 1.61‰,and the rate of ventilator-associated pneumonia was 24.87‰. The majority of 49 detected pathogen were Gram-negative bacteria which occupied 71.43%,and were multiple antibiotic resistance. Conclusions: The rate of hospital infection in ICU is much higher than other divisions in hospital. In the use of instrument,the infection rate of urethral catheter is the highest,and the rate of ventilator-associated pneumonia is the highest in the appliance-related infection. Hospital infectious pathogens are mostly Gram-negative bacteria of multiple antibiotic resistance. So,preventive and control measures should be strengthened to cut off infection passages. Besides,basic and specialized nursing work should be well executed to effectively reduce the rate of hospital infection.

       

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