Strengthening competence building for preventing and controlling health-care-associated infection, improving healthcare-associated infection management level

目的：通过医院感染预防与控制能力建设项目的实施，加强我国医院感染的预防与控制能力，加大医院感染防控措施的落实力度，提升医院感染管理工作水平。方法整个项目包括呼吸机相关肺炎（VAP）、中央静脉插管相关血流感染（CLABSI）、导尿管相关尿路感染（CAUTI）、手术部位感染（SSI）、新生儿病房和新生儿重症监护室（NICU）、血液透析中心（室）、多重耐药菌（MDRO）医院感染防控7个子项目，通过召开项目启动会、基线调查、统一培训，参与项目的医院按照统一的要求、方法与内容进行调查。2013年10月项目正式实施；2013年10月—2014年3月：进行医院感染流行病学及防控措施实施情况的调查；2014年4—9月：实施各项干预防控措施，并监测干预措施的依从性。结果全国共有52所医院参与该项目，49所医院上报数据。重症监护病房（ICU）器械插管相关感染，VAP、CLABSI 和 CAUTI 发病率分别为8．89‰、1．32‰和2．02‰；综合 ICU VAP、CLABSI 和CAUTI 发病率分别为9．6‰、1．4‰和2．2‰。干预前后 ICU VAP、CAUTI 发病率比较，差异均有统计学意义（均P ＜0．05）。ICU 手卫生依从率为76．73％（29361／38267），通过采取干预措施，总依从性和各类医务人员的手卫生依从性均有提升，干预前后比较，差异均有统计学意义（均 P ＜0．05）。结论该项目加大了医院感染各项防控措施的落实力度，降低了相关医院感染发病率，提升了医院感染预防与控制能力，是一种值得推广的模式。Objective Through the implementation of competence building project of healthcare-associated infec-tion(HAI)prevention and control,strengthen the competence for HAI prevention and control in China,promote the implementation of HAI prevention and control measures,and improve HAI management level.Methods The whole project included 7 sub-programmes for prevention and control of HAI :ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI),catheter-associated urinary tract infection (CAUTI),sur-gical site infection (SSI),neonatal ward and neonatal intensive care unit (NICU),hemodialysis center,and multi-drug-resistant organism (MDRO).Through the convening,baseline survey,and unified training,the participated hospitals started the project in accordance with the requirements,methods and contents.The project was initiated from October 2013;from October 2013 to March 2014,the investigation on HAI epidemiology,and implementation of prevention and control measures were carried out;from April to September 2014,various prevention and control intervention measures were conducted,and compliance to intervention measures were monitored .Results A total of 52 hospitals participated in the project,49 hospitals reported the data.Of device-associated infection (DAI)in ICUs,incidences of VAP,CLABSI ,and CAUTI per 1 000 device-days were 8.89‰,1 .32‰ and 2.02‰ respec-tively,in general ICUs were 9.6‰,1 .4‰,and 2.2‰ respectively.Incidences of VAP and CAUTI between before and after intervention were both significantly different(both P <0.05).Hand hygiene compliance rate in ICUs was 76.33%(29 361/38 267).Through taking intervention measures,overall compliance to intervention measures and hand hygiene among health care workers all improved significantly,the differences between before and after inter-vention were all significantly different(all P <0.05).Conclusion The project effectively improved the implementa-tion of prevention and control measures for HAI,reduced the incidence of HAI,and is worthy to be popularized.中国医院协会医院感染预防与控制能力建设项目中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)8507-51