Objective To investigate the current situation of clinical practice of nosocomial infection on nurses from medical institutions so as to provide evidences for policy administrative department to formulate nursing-related nosocomial infection prevention and control, and implement best practice for nosocomial infection.Methods Epidemic disease cross-sectional study was conducted in July 2015. Nosocomial Infection Specialized Committee of Chinese Nursing Association organized medical institution of each province and city, municipality and direct-controlled municipality to carry out investigation at a random date. The investigation content included basic information medical institutions and nursing staffs and three key sites of nosocomial infection (catheter-related bloodstream infection, catheter-associated urinary tract infection and ventilator-associated pneumonia).Results A total of 122 medical institutions from 15 provinces and cities/municipalities/direct-controlled municipalities were involved in the investigation. A number of 11437 questionnaires were collected. On the investigation day, the utilization rates of central venous catheter (CVC), indwelling catheter, trachea cannula/ tracheotomy breathing machine were 2.7%, 4.3% and 1.0%. In terms of patients with indwelling central venous catheter, 44.2% patients had the catheter position of subclavian vein; the proportion of using chlorhexidine sanitizer for puncture skin sterilization was 5.4%; the proportion of no indication and non-renewal of catheter was 41.2%. In terms of patients with indwelling catheter, the proportion of collecting urine sample via cutting off the connection between catheter and urine collection bag was 39.0%; the proportion of patients with conducted bladder irrigation was 22.1%. In terms of patients with trachea cannula/tracheotomy breathing machine, 68.7% of patients used semi-reclining position; the proportion of using chlorhexidine oral cavity solution was 40.1%.Conclusions "Distance" and "gap" exist in clinical practice and best infectious control practice. The sanitation administrative department should formulate corresponding policy and index system to carry out the best clinical practice of nosocomial infection prevention and control on nursing staff.%目的 了解临床护理人员落实医院感染最佳临床实践的现状,为卫生行政部门制定护理相关医院感染预防与控制政策、落实医院感染最佳实践提供科学依据.方法 2015年7月采用流行病学横断面调查的方法,由中华护理学会医院感染护理专业委员会组织各省市/自治区/直辖市医疗机构选取某一个工作日,调查医疗机构及护理人员基本情况和调查当日导管相关血流感染、导管相关尿路感染、呼吸机相关肺炎3种重点部位医院感染最佳实践的落实情况.结果 15个省市/自治区/直辖市122所医疗机构参与了本调查,回收11437份问卷.调查当日,中心静脉导管(CVC)、导尿管、气管插管/气管切开呼吸机使用率分别为2.7%、4.3%和1.0%;在留置中心静脉导管患者中,44.2%置管部位为锁骨下静脉,使用含氯己定成分的消毒剂进行穿刺点皮肤消毒的比例为5.4%,无指征不更换导管的比例为41.2%;在留置导尿管方面,从导尿管与集尿袋的连接处断开留取尿标本的比例为39.0%,22.1%的患者进行了膀胱冲洗;气管插管/气管切开使用呼吸机方面,68.7%的患者为半卧位,使用含氯己定成分口腔护理液进行口腔护理的比例为40.1%.结论 临床实践与感染控制最佳实践之间存在差距,卫生行政部门应该制定相应的政策和指标体系,从顶层设计上推行和落实护理人员医院感染预防与控制最佳临床实践.
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