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目的 探讨国际医疗卫生机构认证联合委员会(JCI)标准对血液净化中心阳性区医院感染控制的影响,降低医院感染,提高血液净化中心阳性区感控管理质量。方法 选取2012年1月-2015年12月医院的3个透析治疗室为研究资料,其中,医院自2014年1月起开始对透析室实施JCI标准进行感染控制,对实施JCI感染措施前、后血液净化中心医务人员的手、物表、空气、透析用水等环境样本进行采样并进行细菌培养,对检查合格率进行分析和对比;观察比较实施JCI感染措施前、后深静脉置管和内瘘感染率、医务人员手卫生依从率指标。结果JCI标准感控工作的措施实施后科室物表、手、空气、反渗水、透析液入口、透析液出口细菌采样合格率分别为98.1%、97.5%、98.0%、95.8%、97.2%、95.8%,高于实施前的84.0%、88.9%、88.0%、83.3%、87.5%、83.3%(P<0.05);内瘘、深静脉置管感染率分别为0.0%、3.3%,低于实施前的15.0%、22.2%(P<0.05);医护人员的手卫生依从性指标有改善。结论 应用JCI标准进行感控管理,能够有效提高血液净化中心隔离区院感管理质量,值得推广应用。
Objective To investigate the influence of JCI standard on nosocomial infection control in positive area of blood purification center, reduce nosocomial infection, and improve the quality of sensory management in the positive area of blood purification center. Methods From January 2012 to December 2015, three dialysis treatment rooms in hospitals were selected as research materials. Among them, the hospital started to implement JCI standard infection control in dialysis room from January 2014, and before and after the implementation of JCI infection measures Blood purification center medical staff hand, surface, air, dialysis water and other environmental samples were sampled and cultured bacteria, check the pass rate analysis and comparison; observed and compared before and after the implementation of JCI infection in deep vein catheterization and fistula Infection rate, medical staff hand hygiene compliance index. Results After the implementation of the JCI standard sensory control measures, the passing rates of bacterial samples at the exit of the table, hand, air, reverse osmosis, dialysate inlet and dialysate were 98.1%, 97.5%, 98.0%, 95.8%, 97.2% and 95.8 %, Higher than those of 84.0%, 88.9%, 88.0%, 83.3%, 87.5% and 83.3% (P <0.05) before implementation; the infection rates of fistula and deep vein catheterization were 0.0% and 3.3% 15.0% before and 22.2% before (P <0.05). The indicators of hand hygiene compliance of health care workers were improved. Conclusion The JCI standard for the management of sensory and control can effectively improve the quality of hospital management in the isolation center of blood purification center, which is worth popularizing and applying.