Risk assessment of nosocomial infection management in outpatient departments_West China Medical Journal

Authors：

XU Chuan , AI Dongyun , LIANG Yanfang , YANG Li , WEI Shiqing , ZOU Mingjun ,  TAN Li

1. Department of Nosocomial Infection Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;

Corresponding?author：

TAN Li, Email: 332116560@qq.com

Keywords：

Risk assessment; outpatient department; nosocomial infection; management

DOI：

10.7507/1002-0179.202401112

Video：

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Objective To explore the application of risk assessment of nosocomial infection control in outpatient departments, so as to find out the high-risk departments and high-risk links of nosocomial infection, and to provide basis for the formulation of nosocomial infection prevention and control measures in outpatient departments. Methods The improved risk assessment tool was used to evaluate the nosocomial infection management risk in the outpatient departments of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. We evaluated risk indicators and risk levels from three dimensions: likelihood of risk occurrence, severity of consequences, and integrity of the current system. Results Among the evaluated outpatient departments, the departments with extremely high risk levels included pediatric fever outpatient department (147.8 points), pediatric outpatient department (141.2 points), emergency internal medicine department (139.4 points), and pediatric emergency department (138.8 points). The departments with high risk levels included internal medicine outpatient department (138.4 points), dermatology outpatient department (136.0 points), otolaryngology-head and neck surgery outpatient department (135.6 points), and ophthalmology outpatient department (134.0 points). The risk assessment scores of 31 outpatient departments showed a normal distribution. The evaluation results of various risk indicators showed that among the 26 risk indicators, there were 2 extremely low risk, 4 low risk, 6 medium low risk, 7 medium high risk, 4 high risk, and 3 extremely high risk. The 3 extremely high risk indicators were lack of nosocomial infection prevention and control knowledge, patients with difficult to identify diseases (air/droplet transmission) seeking medical treatment, and crowded waiting areas for patients. Conclusions The comprehensive risk assessment of outpatient departments can screen out high risk outpatient departments and find out the main risk links. We can concentrate resources on key departments, prevent key risks, and improve the efficiency of nosocomial infection control.

Citation： XU Chuan, AI Dongyun, LIANG Yanfang, YANG Li, WEI Shiqing, ZOU Mingjun, TAN Li. Risk assessment of nosocomial infection management in outpatient departments. West China Medical Journal, 2024, 39(3): 450-454. doi: 10.7507/1002-0179.202401112 Copy

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2.	盛玉慧, 張印蘭, 劉慶明. 標準化持續質量管理在醫院感染管理中的應用價值分析. 中國標準化, 2022(2): 126-128.
3.	劉菲. 基于循證的感染控制流程在門診醫院感染管理中的應用分析. 中國社區醫師, 2023, 39(3): 160-162.
4.	陳萍, 王燕, 段曉菲, 等. 風險評估在傳染病醫院外科醫院感染控制中的應用. 華西醫學, 2017, 32(3): 339-343.
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8.	王允琮, 王力紅, 趙霞, 等. 門診醫護人員呼吸道感染風險評估體系的構建. 中國感染控制雜志, 2021, 20(3): 227-231.
9.	李六億, 徐艷. 醫院感染管理的風險評估. 中國感染控制雜志, 2016, 15(7): 441-446.
10.	陳美利, 景照峰, 黃合田, 等. 風險評估聯合PDCA改善醫院感染管理效果研究. 中國感染控制雜志, 2022, 21(5): 462-468.
11.	徐艷, 楊懷, 張曼, 等. 外科系統醫院感染管理的風險評估研究. 中華醫院感染學雜志, 2017, 27(8): 1890-1892.
12.	Sarkar MK, Arun Babu T, Dey S, et al. Front-line vs second-line healthcare workers: susceptibility prediction to COVID-19 infection in a tertiary care teaching institute. Cureus, 2023, 15(4): e37915.
13.	Conroy G. What’s behind China’s mysterious wave of childhood pneumonia?. Nature, 2023: 27.
14.	Arteche-Eguizabal L, Corcuera-Martínez de Tobillas I, Melgosa-Latorre F, et al. Multidisciplinary collaboration for the optimization of antibiotic prescription: analysis of clinical cases of pneumonia between emergency, internal medicine, and pharmacy services. Antibiotics (Basel), 2022, 11(10): 1336.
15.	Zhang W, Qi X, Yang L, et al. Mpox patients’ experience from infection to treatment and implications for prevention and control: a multicenter qualitative study in China. J Med Virol, 2024, 96(1): e29338.
16.	Arosio AD, Russo F, Coden E, et al. Performing otolaryngological outpatient consultation during the Covid-19 pandemic. Am J Otolaryngol, 2021, 42(2): 102873.
17.	Wang J, Tao Z, Zhang K, et al. Infection control-based construction of a fever outpatient routine management model. Emerg Med Int, 2022, 2022: 2902800.
18.	呂倩, 賴曉全, 徐敏, 等. 基于醫療失效模式與效應分析法的發熱門診醫院感染風險管理. 中華醫院感染學雜志, 2022, 32(12): 1861-1865.
19.	Dong Q, Kuria A, Weng Y, et al. Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital: a case study in the general hospital of the central theater command, Wuhan, China. Community Dent Oral Epidemiol, 2021, 49(6): 557-564.
20.	干春蘭, 陶思源, 王妍潼, 等. 新型冠狀病毒肺炎疫情期間四川大學華西醫院門診三級預檢分診管理優化探索. 華西醫學, 2021, 36(3): 306-310.
21.	Bredin D, O’Doherty D, Hannigan A, et al. Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-analysis. J Hosp Infect, 2022, 130: 20-33.

1. Qiao F, Huang W, Zong Z, et al. Infection prevention and control in outpatient settings in China-structure, resources, and basic practices. Am J Infect Control, 2018, 46(7): 802-807.
2. 盛玉慧, 張印蘭, 劉慶明. 標準化持續質量管理在醫院感染管理中的應用價值分析. 中國標準化, 2022(2): 126-128.
3. 劉菲. 基于循證的感染控制流程在門診醫院感染管理中的應用分析. 中國社區醫師, 2023, 39(3): 160-162.
4. 陳萍, 王燕, 段曉菲, 等. 風險評估在傳染病醫院外科醫院感染控制中的應用. 華西醫學, 2017, 32(3): 339-343.
5. 李六億, 徐艷, 賈建俠, 等. 醫院感染管理的風險評估分析. 中華醫院感染學雜志, 2016, 26(11): 2607-2610.
6. Uguen M, Daniel L, Cosse M, et al. Influence of risk assessment inspection on the prevention of nosocomial infection. J Hosp Infect, 2016, 93(3): 315-317.
7. 國家衛生健康委. 國家衛生健康委關于印發《三級醫院評審標準(2022年版)》及其實施細則的通知. 中華人民共和國國家衛生健康委員會公報, 2022(12): 15.
8. 王允琮, 王力紅, 趙霞, 等. 門診醫護人員呼吸道感染風險評估體系的構建. 中國感染控制雜志, 2021, 20(3): 227-231.
9. 李六億, 徐艷. 醫院感染管理的風險評估. 中國感染控制雜志, 2016, 15(7): 441-446.
10. 陳美利, 景照峰, 黃合田, 等. 風險評估聯合PDCA改善醫院感染管理效果研究. 中國感染控制雜志, 2022, 21(5): 462-468.
11. 徐艷, 楊懷, 張曼, 等. 外科系統醫院感染管理的風險評估研究. 中華醫院感染學雜志, 2017, 27(8): 1890-1892.
12. Sarkar MK, Arun Babu T, Dey S, et al. Front-line vs second-line healthcare workers: susceptibility prediction to COVID-19 infection in a tertiary care teaching institute. Cureus, 2023, 15(4): e37915.
13. Conroy G. What’s behind China’s mysterious wave of childhood pneumonia?. Nature, 2023: 27.
14. Arteche-Eguizabal L, Corcuera-Martínez de Tobillas I, Melgosa-Latorre F, et al. Multidisciplinary collaboration for the optimization of antibiotic prescription: analysis of clinical cases of pneumonia between emergency, internal medicine, and pharmacy services. Antibiotics (Basel), 2022, 11(10): 1336.
15. Zhang W, Qi X, Yang L, et al. Mpox patients’ experience from infection to treatment and implications for prevention and control: a multicenter qualitative study in China. J Med Virol, 2024, 96(1): e29338.
16. Arosio AD, Russo F, Coden E, et al. Performing otolaryngological outpatient consultation during the Covid-19 pandemic. Am J Otolaryngol, 2021, 42(2): 102873.
17. Wang J, Tao Z, Zhang K, et al. Infection control-based construction of a fever outpatient routine management model. Emerg Med Int, 2022, 2022: 2902800.
18. 呂倩, 賴曉全, 徐敏, 等. 基于醫療失效模式與效應分析法的發熱門診醫院感染風險管理. 中華醫院感染學雜志, 2022, 32(12): 1861-1865.
19. Dong Q, Kuria A, Weng Y, et al. Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital: a case study in the general hospital of the central theater command, Wuhan, China. Community Dent Oral Epidemiol, 2021, 49(6): 557-564.
20. 干春蘭, 陶思源, 王妍潼, 等. 新型冠狀病毒肺炎疫情期間四川大學華西醫院門診三級預檢分診管理優化探索. 華西醫學, 2021, 36(3): 306-310.
21. Bredin D, O’Doherty D, Hannigan A, et al. Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-analysis. J Hosp Infect, 2022, 130: 20-33.

West China Medical Journal

Risk assessment of nosocomial infection management in outpatient departments

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