Effect of ECRS management mode on nosocomial infection prevention and control quality of multidrug-resistant organisms_West China Medical Journal

Authors：

ZHANG Min ¹ , HUANG Yaqin ² , XUAN Shanshan ³ , LIU Ying ⁴ ,  ZHOU Bin ¹

1. Department of Nosocomial Infection Management, the First Hospital of Nanchang, Nanchang, Jiangxi 330008, P. R. China;
2. Department of Gastroenterology, the First Hospital of Nanchang, Nanchang, Jiangxi 330008, P. R. China;
3. Department of Endocrinology, the First Hospital of Nanchang, Nanchang, Jiangxi 330008, P. R. China;
4. Department of Hepatobiliary and Pancreatic Surgery, the First Hospital of Nanchang, Nanchang, Jiangxi 330008, P. R. China;

Corresponding?author：

ZHOU Bin, Email: 1291558235@qq.com

Keywords：

Multidrug-resistant organism; prevention and control; nosocomial infection management; ECRS management mode

DOI：

10.7507/1002-0179.202211103

Video：

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Objective To evaluate the effect of ECRS management model on the quality of prevention and control of hospital infection with multidrug-resistant organisms (MDROs). Methods The data related to the prevention and control of MDROs in the First Hospital of Nanchang in 2020 and 2021 were retrospectively collected. The hospital implemented routine MDRO infection prevention and control management in accordance with the Expert Consensus on the Prevention and Control of Multi-drug Resistant Bacteria Nosocomial Infection in 2020. On this basis, the hospital applied the four principles of the ECRS method to cancel, combine, rearrange and simplify the MDRO infection prevention and control management. The detection rate of MDROs on object surfaces, the incidence rate of hospital infection of MDROs, the compliance rate of hand hygiene, the implementation rate of contact isolation prevention and control measures, and the pass rate of MDRO infection prevention and control education assessment were analyzed and compared between the two years. Results The detection rate of MDROs on the surfaces in 2021 was lower than that in 2020 (9.39% vs. 31.63%). The hospital-acquired MDRO infection rate in 2021 was lower than that in 2020 (1.18% vs. 1.46%). The hand hygiene compliance rates of medical staff, workers and caregivers in 2021 were higher than those in 2020 (90.99% vs. 78.63%, 73.51% vs. 45.96%, 70.96% vs. 33.71%). The implementation rate of contact isolation prevention and control measures in 2021 was higher than that in 2020 (93.31% vs. 70.79%). The qualified rates of MDRO infection prevention and control education in medical personnel, workers and caregivers in 2021 were higher than those in 2020 (96.57% vs. 81.31%, 76.47% vs. 47.95%, 73.17% vs. 34.19%). All the differences above were statistically significant (P<0.05). Conclusion ECRS management mode can improve the execution and prevention level of MDRO hospital infection prevention and control, and reduce the incidence of MDRO hospital infection.

Citation： ZHANG Min, HUANG Yaqin, XUAN Shanshan, LIU Ying, ZHOU Bin. Effect of ECRS management mode on nosocomial infection prevention and control quality of multidrug-resistant organisms. West China Medical Journal, 2023, 38(3): 374-379. doi: 10.7507/1002-0179.202211103 Copy

1.	袁曉寧. 多重耐藥菌的形成機理及其防控措施研究進展. 中國消毒學雜志, 2016, 33(8): 792-796.
2.	黃晶, 劉燕瑜, 周樹麗, 等. 多中心統一的環境清潔消毒措施對 ICU 患者和周圍高頻接觸物體表面多藥耐藥菌檢出率的影響. 中華醫院感染學雜志, 2017, 27(15): 3575-3578.
3.	凌玲, 吳偉旋, 孫樹梅, 等. 多重耐藥菌醫院感染直接經濟負擔的系統評價. 中國感染控制雜志, 2017, 16(7): 616-621.
4.	繆玉秀, 高煥新, 許蜜. 精益管理在多重耐藥菌醫院感染預防與控制中的應用研究. 實用臨床醫藥雜志, 2017, 21(19): 207-209.
5.	楊啟文, 吳安華, 胡必杰, 等. 臨床重要耐藥菌感染傳播防控策略專家共識. 中國感染控制雜志, 2021, 20(1): 1-14.
6.	Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect, 2014, 20(Suppl 1): 1-55.
7.	孟秀娟, 吳安華. 如何應對多重耐藥菌醫院感染的嚴峻挑戰. 中國感染控制雜志, 2019, 18(3): 185-192.
8.	譚善娟, 李玲, 邱蔓, 等. 多學科協作聯合集束化管理對 ICU 多重耐藥菌感染預防的效果. 中國感染控制雜志, 2018, 17(2): 156-159.
9.	盛義平. ECRS 法在 NICU 患者感控管理流程中的應用. 中醫藥管理雜志, 2021, 29(2): 159-160.
10.	余江, 周來新, 胡琳, 等. 基于 ECRS 法的大型醫院門診服務流程優化. 中國醫院, 2016, 20(11): 79-80.
11.	黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
12.	Ekpanyapong S, Reddy KR. Infections in cirrhosis. Curr Treat Options Gastroenterol, 2019, 17(2): 254-270.
13.	鄭雷剛. 實習護生多重耐藥菌感染控制知識認知程度的調查分析. 全科護理, 2020, 18(13): 1661-1664.
14.	熊妙華, 陳小平, 丘文軍, 等. 精益管理在降低多重耐藥菌院感率中的應用效果. 中國醫藥指南, 2021, 19(13): 4-7.
15.	陳崗, 楊正麗, 孫桂香. 住院患者陪護人手衛生依從性及其影響因素. 中國消毒學雜志, 2018, 35(1): 44-46.
16.	韓穎, 王艾嘉, 田磊, 等. 環境篩查系列措施對 ICU 物體表面多重耐藥菌檢出率的影響. 中國感染控制雜志, 2021, 20(6): 499-504.
17.	常文燕, 陳曉兵, 李燁, 等. 基于接觸路徑分析多重耐藥菌感染患者陪護人員手衛生依從性. 醫學理論與實踐, 2021, 34(21): 3831-3833.
18.	孫青, 陳慧麗, 蔣娜, 等. 精益管理在神經內科多重耐藥管理的應用效果. 中國實用醫藥, 2019, 14(19): 162-164.
19.	趙鋮, 肖玲琴. 信息支持與管理互補模式下醫院感染監測工作的進展. 中醫藥管理雜志, 2021, 29(11): 188-189.
20.	高艷, 周泓羽, 趙慶華, 等. 醫院感染的衛生經濟學研究現狀及啟示. 中國衛生資源, 2021, 24(5): 520-524.
21.	國家醫保局, 財政部, 國家衛生健康委員會, 等. 國家醫保局財政部國家衛生健康委國家中醫藥局關于印發按疾病診斷相關分組付費國家試點城市名單的通知: 醫保發﹝2019﹞34 號. 2019-06-15.
22.	陶莉, 張冰琦, 黃郁竹, 等. 多學科協作聯合精準化監管模式在神經外科重癥監護室多重耐藥菌感染防控中的實踐與效果. 當代醫學, 2019, 25(32): 121-124.
23.	Rosenthal VD, Desse J, Maurizi DM, et al. Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of central line-associated bloodstream infection in 14 intensive care units in 11 hospitals of 5 cities in Argentina. Infect Control Hosp Epidemiol, 2018, 39(4): 445-451.
24.	蔡虻, 劉聚源. 多重耐藥菌醫院感染防控策略與思考. 中國護理管理, 2018, 18(12): 1590-1594.
25.	陳亞男, 劉菁, 田麗梅, 等. ICU 多重耐藥菌目標性監測與干預效果分析. 中國感染控制雜志, 2017, 16(1): 58-61, 65.
26.	Spatenkova V, Bradac O, Fackova D, et al. Low incidence of multidrug-resistant bacteria and nosocomial infection due to a preventive multimodal nosocomial infection control: a 10-year single centre prospective cohort study in neurocritical care. BMC Neurol, 2018, 18(1): 23.

1. 袁曉寧. 多重耐藥菌的形成機理及其防控措施研究進展. 中國消毒學雜志, 2016, 33(8): 792-796.
2. 黃晶, 劉燕瑜, 周樹麗, 等. 多中心統一的環境清潔消毒措施對 ICU 患者和周圍高頻接觸物體表面多藥耐藥菌檢出率的影響. 中華醫院感染學雜志, 2017, 27(15): 3575-3578.
3. 凌玲, 吳偉旋, 孫樹梅, 等. 多重耐藥菌醫院感染直接經濟負擔的系統評價. 中國感染控制雜志, 2017, 16(7): 616-621.
4. 繆玉秀, 高煥新, 許蜜. 精益管理在多重耐藥菌醫院感染預防與控制中的應用研究. 實用臨床醫藥雜志, 2017, 21(19): 207-209.
5. 楊啟文, 吳安華, 胡必杰, 等. 臨床重要耐藥菌感染傳播防控策略專家共識. 中國感染控制雜志, 2021, 20(1): 1-14.
6. Tacconelli E, Cataldo MA, Dancer SJ, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect, 2014, 20(Suppl 1): 1-55.
7. 孟秀娟, 吳安華. 如何應對多重耐藥菌醫院感染的嚴峻挑戰. 中國感染控制雜志, 2019, 18(3): 185-192.
8. 譚善娟, 李玲, 邱蔓, 等. 多學科協作聯合集束化管理對 ICU 多重耐藥菌感染預防的效果. 中國感染控制雜志, 2018, 17(2): 156-159.
9. 盛義平. ECRS 法在 NICU 患者感控管理流程中的應用. 中醫藥管理雜志, 2021, 29(2): 159-160.
10. 余江, 周來新, 胡琳, 等. 基于 ECRS 法的大型醫院門診服務流程優化. 中國醫院, 2016, 20(11): 79-80.
11. 黃勛, 鄧子德, 倪語星, 等. 多重耐藥菌醫院感染預防與控制中國專家共識. 中國感染控制雜志, 2015, 14(1): 1-9.
12. Ekpanyapong S, Reddy KR. Infections in cirrhosis. Curr Treat Options Gastroenterol, 2019, 17(2): 254-270.
13. 鄭雷剛. 實習護生多重耐藥菌感染控制知識認知程度的調查分析. 全科護理, 2020, 18(13): 1661-1664.
14. 熊妙華, 陳小平, 丘文軍, 等. 精益管理在降低多重耐藥菌院感率中的應用效果. 中國醫藥指南, 2021, 19(13): 4-7.
15. 陳崗, 楊正麗, 孫桂香. 住院患者陪護人手衛生依從性及其影響因素. 中國消毒學雜志, 2018, 35(1): 44-46.
16. 韓穎, 王艾嘉, 田磊, 等. 環境篩查系列措施對 ICU 物體表面多重耐藥菌檢出率的影響. 中國感染控制雜志, 2021, 20(6): 499-504.
17. 常文燕, 陳曉兵, 李燁, 等. 基于接觸路徑分析多重耐藥菌感染患者陪護人員手衛生依從性. 醫學理論與實踐, 2021, 34(21): 3831-3833.
18. 孫青, 陳慧麗, 蔣娜, 等. 精益管理在神經內科多重耐藥管理的應用效果. 中國實用醫藥, 2019, 14(19): 162-164.
19. 趙鋮, 肖玲琴. 信息支持與管理互補模式下醫院感染監測工作的進展. 中醫藥管理雜志, 2021, 29(11): 188-189.
20. 高艷, 周泓羽, 趙慶華, 等. 醫院感染的衛生經濟學研究現狀及啟示. 中國衛生資源, 2021, 24(5): 520-524.
21. 國家醫保局, 財政部, 國家衛生健康委員會, 等. 國家醫保局財政部國家衛生健康委國家中醫藥局關于印發按疾病診斷相關分組付費國家試點城市名單的通知: 醫保發﹝2019﹞34 號. 2019-06-15.
22. 陶莉, 張冰琦, 黃郁竹, 等. 多學科協作聯合精準化監管模式在神經外科重癥監護室多重耐藥菌感染防控中的實踐與效果. 當代醫學, 2019, 25(32): 121-124.
23. Rosenthal VD, Desse J, Maurizi DM, et al. Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of central line-associated bloodstream infection in 14 intensive care units in 11 hospitals of 5 cities in Argentina. Infect Control Hosp Epidemiol, 2018, 39(4): 445-451.
24. 蔡虻, 劉聚源. 多重耐藥菌醫院感染防控策略與思考. 中國護理管理, 2018, 18(12): 1590-1594.
25. 陳亞男, 劉菁, 田麗梅, 等. ICU 多重耐藥菌目標性監測與干預效果分析. 中國感染控制雜志, 2017, 16(1): 58-61, 65.
26. Spatenkova V, Bradac O, Fackova D, et al. Low incidence of multidrug-resistant bacteria and nosocomial infection due to a preventive multimodal nosocomial infection control: a 10-year single centre prospective cohort study in neurocritical care. BMC Neurol, 2018, 18(1): 23.

West China Medical Journal

Effect of ECRS management mode on nosocomial infection prevention and control quality of multidrug-resistant organisms

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