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目的了解成都市犬伤门诊医院感染管理现状,为进一步完善院感防控措施提供依据和参考。方法采用问卷调查和现场观察相结合的方法,于2012年8-10月对成都市21个犬伤门诊院感管理现况和163名医务人员的院感防控措施进行调查。调查内容主要包括院感制度建设、硬件配置、消毒隔离等。结果 21个犬伤门诊都有院感管理部门,但是部分门诊履职不充分;大部分犬伤门诊(81.0%,17/21)是兼职门诊,功能分区不完整(76.2%,16/21),布局不完全合理(占81.0%,17/21);消毒设备和医疗废物管理不完全规范;市级以上门诊医务人员工作服穿戴正确执行率、手卫生措施和操作流程执行率分别为91.11%、66.67%和84.22%;区级门诊在这三方面分别为83.33%、52.78%和83.33%;社区级门诊分别为70.73%、40.24%和57.31%。3个级别犬伤门诊的医务人员在工作服穿戴、手卫生措施和流程执行率方面差异有统计学意义(P<0.05),市级及以上门诊最好,社区级门诊最差;而在操作符合院感要求执行率方面差异无统计学意义(P>0.05)。结论成都市犬伤门诊院感管理不够规范,应针对不同级别门诊的院感管理现况,提高犬伤门诊院感防控能力,有效预防院感的发生。
Objective To understand the status quo of hospital infection management in dog outpatient clinics in Chengdu and to provide basis and references for further improvement of hospital control measures. Methods By means of a combination of questionnaires and on-the-spot observation, we conducted a survey on the status of nosocomial management and the control measures of nosocomial infection of 21 medical staff in 21 dogs in May-October 2012 in Chengdu. The survey includes hospital system, hardware configuration, disinfection and isolation. Results Most of the outpatient departments of dog-related injuries were hospitalized with nosocomial management, but some out-patient departments performed inadequate duties. Most of the outpatients with canine injuries (81.0%, 17/21) were part-time clinics with incomplete functional subdivision (76.2%, 16/21) (81.0%, 17/21). The disinfection equipment and medical waste management were not completely standardized. The correct implementation rate of medical workers wearing clothes at the municipal level or above, hand hygiene measures and operational procedures implementation rates were 91.11% 66.67% and 84.22% respectively; district-level clinics were 83.33%, 52.78% and 83.33% respectively in these three areas; and community clinics were 70.73%, 40.24% and 57.31% respectively. There were significant differences in the health care workers’ wear rate and hand hygiene rate (P <0.05) among the three levels of dog-wounded outpatients, the best at the municipal level and above, and the worst among community level clinics. However, There was no significant difference in the implementation rate of hospital feeling (P> 0.05). Conclusions The hospital management of inpatient canine in Chengdu is not standardized enough. The status of hospital management in different levels of outpatient clinic should be improved to improve the prevention and control of hospitalized invaders and effectively prevent the occurrence of hospital sensation.