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目的了解我国护理人员在落实手术部位感染预防与控制最佳实践的现状,为卫生行政部门制定相关医院感染预防与控制政策、落实医院感染最佳实践提供科学依据。方法 2015年7月1-30日采用流行病学横断面调查方法,调查医院及护理人员基本情况和调查当日手术部位感染最佳实践的落实情况。结果 15个省市/自治区/直辖市122所医院参与了调查,发放调查问卷3 629份,回收3 520份,回收率为97.00%;三级医院101所占82.7%,公立医院118所占96.7%,综合医院101所占82.7%,参与调查的医院平均开放床位数1 001张,在岗护理人员574名;在围术期护理方面,5.7%的患者备皮方式为剪毛,1.7%的患者使用了含氯己定成分浴液,监测血糖/控制血糖和术中保温纳入医嘱的比例分别为46.3%和3.6%;去除毛发的方式、去毛时间、使用氯己定成分的浴液进行术前沐浴等,在二、三级医院分布差异有统计学意义(P<0.05)。结论围术期护理临床实践与感染控制最佳实践之间存在距离和鸿沟,卫生行政部门应该制定相应的政策和指标体系,从顶层设计上推行和落实护理人员围术期管理,预防与控制手术部位感染。
Objective To understand the status quo of nurses in our country in implementing best practices in prevention and control of infection at surgical sites and provide scientific basis for health administrative departments to formulate relevant hospital infection prevention and control policies and to implement best practices of nosocomial infections. Methods From July 1 to July 30, 2015, the epidemiological cross-sectional survey method was used to investigate the basic situation of hospitals and nurses and the implementation of best practices in surgical site infection on the day of investigation. Results 122 hospitals in 15 provinces, autonomous regions and municipalities participated in the survey, 3 629 questionnaires were distributed and 3 520 were recovered with a recovery rate of 97.00%. 101 hospitals accounted for 82.7%, and public hospitals 118 accounted for 96.7% , 101.7% of general hospitals, 82% of the total number of open hospitals in the surveyed hospitals, and 574 on-the-job nursing staff. In perioperative nursing, 5.7% of the patients had skin-cutting methods and 1.7% of the patients used Chlorhexidine composition of the bath, monitoring blood glucose / blood glucose control and intraoperative infusion into the doctor’s advice ratio was 46.3% and 3.6%; the way to remove the hair, hair removal time, the use of chlorhexidine composition bath for preoperative bathing In the second and third class hospitals, the differences were statistically significant (P <0.05). Conclusion There is a gap between the best practice of perioperative nursing and infection control. The health administrative department should formulate the corresponding policy and index system, and carry out perioperative management and prevention and control of nurses from the top-level design Parts of the infection.