甲型H1N1流感流行期间非隔离病房综合消毒防护措施的作用

摘要

Objective To decrease the incidence of nosocomial respiratory infectious diseases in the non-isolation wards during H1N1 epidemic period by setting up comprehensive disinfection and prevention measures.Methods Digestive department 2 was as group A which enforced comprehensive disinfection and prevention measures:scientific education; new relatives' visiting and assisting system; intensifying standardized ward ventilation and disinfection.Digestive department 1 was as group B (control group), the measures were: reducing visiting, disinfecting the wards with ozone once a week.The knowledge about prevention and control of H1N1 among inpatients , assisting persons , visitors and healthcare workers before and after conducting education , as well as the bacterial count and the occurrence of nosocomial infection (NI) were compared.Results After conducting scientific education, the knowledge about prevention and control of H1N1 improved obviously , the average score increased from 43.85 before education to 94.55 after education (P＜0.0001); the number of visitors decreased from 12 532 before education to 4 385 after education, the number of bacteria in group A were (21.63 ± 12.94)CFU/m3, which was significantly lower than (903.46± 241.73)CFU/m3 of group B (P＜0.0001 ); NI rate and upper respiratory tract infection rate was 0.48％ and 0.00％ respectively , which were obviously lower than 3.36％ and 1.92％ before education respectively (both P＜0.05).No H1N1 case occurred.Concusion During H1N1 outbreak and epidemic period , the enforcement of strict and comprehensive disinfection and prevention measures and education can enhance the knowledge of patients, patients'relatives and healthcare workers, which is important for the reducing of NI and upper respiratory tract infection.%目的 通过制定一整套综合消毒防护措施,降低甲型H1N1流感(甲流)流行期间非隔离病房医院呼吸道传染性疾病的发生率.方法 以该院消化二科作为综合消毒防护示范病房(A组):科学宣教;制定新的家属探视及陪护制度;加强病房通风及规范消毒.消化一科为对照(B组),其措施为:减少探视;病室每周用臭氧机消毒1次.调查并比较上述2组住院患者、陪护人员、探视人员和医务人员在宣教前后甲流防控知识知晓情况及病房的空气菌落数、医院感染情况.结果 在科学宣教后,所有研究对象对甲流防控知识的知晓率明显提高,平均得分由宣教前的43.85分提高至宣教后的94.55分(P＜0.0001);探视人次由宣教前的12 532人次减少至宣教后的4 385人次.A组病房的空气菌落数(21.63±12.94)CFU/m3明显少于B组(903.46±241.73)CFU/m3(P＜0.0001);医院感染率(0.48%)及上呼吸道感染率(0.00%)亦明显低于实施制定的措施前(分别为3.36%、1.92%)(均P＜0.05).无甲流病例出现.结论 在甲流暴发和流行期间,严格、综合的消毒防护措施及宣教的实施,可以提高患者、家属及医务人员的认知能力,对于减少医院感染及上呼吸道感染,积极应对突发事件,有重要的作用.