本文選題：消毒質量　切入點：醫(yī)院感染　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:1.通過對2011-2016年寧夏地區(qū)醫(yī)療機構消毒質量監(jiān)測數據的整理分析,了解該地區(qū)醫(yī)療機構的清洗、消毒和滅菌質量,為相關政策法規(guī)、標準規(guī)范的修訂提供依據。2.對銀川部分醫(yī)療機構采取干預措施,比較干預前后消毒質量的變化,掌握消毒工作的薄弱環(huán)節(jié),確定切實有效的改進措施,為加強醫(yī)院感染控制提供參考依據。3.對院感發(fā)生關鍵環(huán)節(jié)手衛(wèi)生進行現況調查,評估手衛(wèi)生消毒質量及影響因素,找出重點人群和適宜的洗消方法,為更好的控制由手衛(wèi)生問題引起的醫(yī)院感染提供借鑒。方法:1.收集各市、縣(區(qū))疾病預防控制中心上報的2011-2016年各級醫(yī)療機構的監(jiān)測數據,將這些數據進行錄入、匯總、分析和總結。2.隨機抽取寧夏銀川市三級、二級、一級醫(yī)療機構各1家,以這3家醫(yī)療機構的醫(yī)務人員作為干預研究對象,采取宣傳培訓、現場技術指導、領導座談,結果反饋等綜合干預措施,在干預前后進行問卷調查和消毒質量監(jiān)測,對干預情況進行評價和分析,比較干預前后醫(yī)院消毒水平的變化。3.隨機抽取寧夏銀川市三級、二級、一級醫(yī)療機構各1家,以這3家醫(yī)療機構的醫(yī)務人員作為研究對象,通過問卷調查和手衛(wèi)生監(jiān)測,了解手衛(wèi)生知識掌握情況,評價不同等級醫(yī)院、不同崗位和不同手衛(wèi)生方式的消毒效果。結果:1.2011-2016年寧夏地區(qū)醫(yī)療機構消毒質量監(jiān)測共采樣71765份,總合格率為92.32%,各年度消毒質量監(jiān)測合格率差異有統計學意義(χ2=572.21,P0.001);不同等級醫(yī)療機構合格率的差別有統計學意義(χ2=1182.16,P0.001);紫外線燈和室內空氣合格率較低,分別為89.71%和83.91%。2.干預前后問卷平均得分差異有統計學意義(t=65.13,P0.001);干預前后手術室空氣(χ2=11.35,P0.001)、環(huán)境物體表面(P0.05)、手衛(wèi)生(χ2=22.07,P0.001)、醫(yī)療器械(χ2=13.63,P0.001)、醫(yī)療用水(χ2=4.9,P0.05)合格率的差異有統計學意義;外科手(P0.05)、內鏡(χ2=2.27,P0.05)合格率的差異無統計學意義。3.不同等級醫(yī)院(F=11.99,P0.001)、不同科室(F=4.42,P0.05)手衛(wèi)生知識得分差異有統計學意義。手衛(wèi)生總體合格率為67.35%,不同等級醫(yī)院(χ2=19.33,P0.05)、醫(yī)生和護士(χ2=22.46,P0.05)、四種不同手衛(wèi)生方式(χ2=37.57,F0.05)手衛(wèi)生合格率差異均具有統計學意義。結論:1.一級以下醫(yī)療機構消毒質量較差,是今后消毒質量監(jiān)測的重點,相關部門應加強監(jiān)督檢查力度,提高其消毒水平。2.紫外線燈和室內空氣是寧夏地區(qū)醫(yī)療機構消毒工作的薄弱環(huán)節(jié),應該進一步加強醫(yī)院消毒管理,定期監(jiān)測,改進消毒方法,改善消毒設備。3.采取宣傳培訓、現場技術指導、領導座談和結果反饋等綜合干預措施,可以提高醫(yī)務人員消毒衛(wèi)生知識水平,完善醫(yī)院感染管理組織,健全消毒滅菌制度,增高消毒質量合格率。4.衛(wèi)生手消毒是一種簡便、快捷、強效的手衛(wèi)生方式,在手部沒有可見污染時,可以直接使用快速手消代替肥皂或洗手液洗手。
[Abstract]:Objective to analyze the monitoring data of disinfection quality of medical institutions in Ningxia during 2011-2016, and to understand the cleaning, disinfection and sterilization quality of medical institutions in Ningxia, which are related policies and regulations. The revision of standards and norms provides the basis for intervention measures for some medical institutions in Yinchuan, compares the changes in disinfection quality before and after intervention, grasps the weak links of disinfection work, and determines practical and effective improvement measures. To provide reference basis for strengthening nosocomial infection control. 3. To investigate the status of hand hygiene in the key link of nosocomial infection, to evaluate the quality of hand hygiene disinfection and its influencing factors, and to find out the key population and the appropriate method of disinfecting. To provide reference for better control of nosocomial infections caused by hand hygiene problems. Methods: 1. Collect the surveillance data reported by the Centers for Disease Prevention and Control of cities and Counties (districts) for 2011-2016 at all levels of medical institutions, and input and collect these data. Analysis and summary .2. random selection of three, two, and one medical institutions in Yinchuan, Ningxia. Take the medical personnel of these three medical institutions as the objects of intervention, take propaganda and training, on-site technical guidance, and lead discussions, Results feedback and other comprehensive intervention measures, questionnaire survey and disinfection quality monitoring were carried out before and after intervention, and the intervention situation was evaluated and analyzed, and the changes of hospital disinfection level before and after intervention were compared .3.The third and second levels of Yinchuan City were randomly selected. The medical staff of these three medical institutions were taken as the research objects. Through questionnaire survey and hand hygiene monitoring, the knowledge of hand hygiene was understood, and the hospitals of different grades were evaluated. Results 71765 samples were collected from the monitoring of disinfection quality of medical institutions in Ningxia from 2011 to 2016. The total qualified rate was 92.32, the difference of the qualified rate of disinfection quality monitoring was statistically significant (蠂 2 / 572.21 / P 0.001), the difference of qualified rate between different grades of medical institutions was statistically significant (蠂 ~ 2 / 2 = 1182.16 / P 0.001), the qualified rate of ultraviolet lamp and indoor air was lower than that of control group (P < 0.05). The average scores of questionnaire before and after intervention were 89.71% and 83.91.2.The average scores of questionnaire before and after intervention were statistically significant, the air of operating room before and after intervention (蠂 ~ 2 ~ 2 ~ (11.35)) P _ (0.001), the surface of environmental objects (P _ (0.05)), hand hygiene (蠂 ~ (2) ~ (22) 0.7p _ (0.001), medical instruments (蠂 ~ (213.63N) P _ (0.001)), medical water (蠂 ~ (2) (4.9N) P 0.05) were significantly different. There was no significant difference in the pass rate between the two groups (蠂 2 / 2.27 / P 0.05). 3. There were significant differences in the scores of hand hygiene knowledge in different grade hospitals (蠂 2 / 319.3n / P 0.05) and in different departments (P = 4.42 / P 0.05). The total pass rate of hand hygiene was 67.35, and that of hospitals of different grades (蠂 2 / 319.3n / P 0.05) was higher than that of other hospitals (蠂 ~ 2 / 319.3 / P = 0.05), and the scores of doctors and nurses were higher than those of other hospitals (蠂 ~ 2 / 319.3 / P = 0.05). (蠂 ~ 2 ~ 2 ~ (22.46) P _ (0.05)), four different hand hygiene methods (蠂 ~ (2)) (蠂 ~ (2)) (蠂 ~ (2)) ~ (37.57) F _ (0.05) had statistical significance. Conclusion: 1. The disinfection quality of medical institutions below grade one is poor. It is the key point of disinfection quality monitoring in the future. The relevant departments should strengthen supervision and inspection to improve the disinfection level. Ultraviolet lamp and indoor air are the weak links in disinfection work of medical institutions in Ningxia area, and hospital disinfection management should be further strengthened. Regular monitoring, improvement of disinfection methods, improvement of disinfection equipment, adoption of comprehensive intervention measures such as propaganda and training, on-site technical guidance, leadership talks and feedback of results can improve the knowledge level of disinfection and hygiene of medical personnel. Improve the hospital infection management organization, perfect the disinfection and sterilization system, increase the qualified rate of disinfection quality .4.The sanitary hand disinfection is a simple, fast and powerful hand hygiene method, when there is no visible contamination in the hand, Instead of soap or hand sanitizer, you can use quick hand sanitizers directly.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R187

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