倪丹

[摘要]目的 探讨医护一体化管理对神经外科住院患者医院感染的防控效果。方法 选取2016年8月～2017年8月在三级甲等综合性医院南昌大学第四附属医院神经外科的住院患者100例，根据患者入院时间顺序，分单双号将患者进行分组，每组50例。对照组采用常规医疗护理模式管理，观察组采用医护一体化管理模式管理。比较两组患者的院感发生率及患者的满意度，比较观察组干预前后医护人员洗手法准确性及手卫生依从性。 结果 观察组的院感发生率为4.00%，低于对照组的20.00%，差异有统计学意义（P<0.01）；观察组中，干预前，医务人员6步洗手法准确率为88.9%，依从性为81.15%，干预后分别为100.0%、95.86%，干预前后的上述指标差异有统計学意义（P<0.01）。观察组对科室的总满意度为90.00%，显著高于对照组的60.00%，差异有统计学意义（P<0.01）。 结论 对神经外科住院患者实施医护一体化管理，可有效控制院内感染率，提高患者的生命质量和满意度，提高医护人员手卫生依从性。

[关键词]医护一体化管理；神经外科；医院感染

[中图分类号] R197.3 [文献标识码] A [文章编号] 1674-4721（2017）11（c）-0126-03

Study on the application of integrated management of doctors and nurses preventing nosocomial infection in neurosurgery

NI Dan

Department of Neurosurgery，the Fourth Affiliated Hospital of Nanchang University，Jiangxi Province，Nanchang 330002，China

[Abstract]Objective To explore the prevention and control effect of integrated management of doctors and nurses in inpatients of neurosurgery.Methods 100 inpatients in neurosurgery of the Fourth Affiliated Hospital of Nanchang University of three-level and first class general hospital was selected from August 2016 to August 2017 and they were grouped according to even and odd-numbered of their admission time sequence.The control group was given the the routine medical care mode management，while the observation group was given the integrated management of doctors and nurses.The incidence of nosocomial infection and the satisfaction degree of patients were compared between the two groups，and the accuracy of hand washing and compliance of hand hygiene among medical staff in the observation group before and after intervention were compared.Results The incidence of nosocomial infection in the observation group （4.00%） was lower than that of the control group （20.00%），and there was a statistical difference （P<0.01）.In the observation group，before intervention，the accuracy rate of six-step hand-washing method was 88.9% and compliance was 81.15%，after intervention，the above-mentioned indexes was 100.0% and 95.86% respectively，and there was a statistical difference before and after intervention （P<0.01）.The total satisfaction degree of the observation group was 90.00% for department，which was significantly higher than of the control group （60.00%），and the difference was statistically significant （P<0.01）.Conclusion Integrated management of doctors and nurses applied in inpatients of neurosurgery can effectively control the rate of nosocomial infection，improve the life quality and satisfaction degree of patients，and improve the compliance of hand hygiene for medical staff.endprint

[Key words]Integrated management of doctors and nurses；Neurosurgery；Nosocomial infection

由于疾病本身以及神经外科患者手术的特殊性，颅脑手术术后患者大多数具有病情危重、手术创伤大、侵入性操作多等特点，神经外科颅脑手术患者在住院期间更易感染[1]。医院感染的发生将会造成患者全身性炎症，延缓出院时间，甚至导致死亡，并且会增加患者及其家庭的经济负担[2]。医院感染的发生严重影响患者的预后，且给患者和社会带来巨大的经济负担[3]。控制医院感染的发生率是衡量医院管理水平，保证医疗安全，提高缓和救治成功率的重要途径[4]。新型医护一体化是指医生和护士之間协作沟通的一种人际关系[5-6]。我院把医护一体化管理模式应用于神经外科预防医院感染的预防，从引起医院感染的3个环节“感染源、感染途径、易感患者”入手，减少神经外科医院感染的发生。……