三级医院 ICU 中心静脉导管相关血流感染预防与控制现状调查及防控策略

摘要

目的：了解某市三级医院ICU中心静脉导管（CVC）相关性血流感染（CRBSI）预防与控制质量安全管理现状，探讨其对策。方法用自行设计的问卷，调查某市8家三级医院ICU CRBSI防控现状，分析252名ICU护士CRBSI预防和控制相关知识认知、赞同度及行为情况。结果8家医院中6家医院具有预防CRBSI标准操作规程，2家医院有CVC导管维护专用记录单。基于美国CDC《指南》推荐的循证支持的CRBSI特殊预防措施，各家医院执行不佳。252名ICU护士对导管感染相关知识、组合干预与维护措施赞同度、导管相关感染预防和控制行为得分分别为（55．88±7．46），（20．21±1．48），（72.59±6．83）分。结论某市三级医院ICU缺乏统一的CRBSI预防与控制标准操作规程及CVC置管核查表和维护核查表，应加强医护人员CRBSI防控知识的培训，提升行为依从性，降低CRBSI的发生率，提高危重患者的救治成功率。%Objective To understand the current situation of the prevention and control of central venous catheter-related bloodstream infections ( CRBSI ) in ICU of three-level hospital , and explore the countermeasures .Methods The self-designed questionnaires were used in the study .The prevention and control and the quality management of ICUCRBSI at present in eight hospital were investigated ; and the cognition, the agree degree and the behavior of the related knowledge of the prevention and control of CRBSI in 252 nurses were also investigated .Results Six hospitals in eight hospitals had the standard operating procedure for the prevention and control of CRBSI , and two hospitals had the special check list for the maintenance of central venous catheter ( CVC) .The special prevention and control of CRBSI supported by the guideline of CDC in the USA was poorly carried out in the different hospital .The scores of the cognition , the agree degree and the behavior of the related knowledge of the prevention and control of CRBSI in 252 nurses were respectively (55.88 ±7.46), (20.21 ±1.48) and (72.59 ±6.83).Conclusions The three-level hospital in one city is lack of the standard operating procedure for the prevention and control of CRBSI , the check list for CVC catheter and maintenance .The medical staff should strengthen the training of the prevention and control of CRBSI , and increase the behavior compliance so as to decrease the incidence of CRBSI and improve the successful rate of rescue in the critically ill patients .