摘要网格化管理以其敏捷、精准和高效的特点在提升社会服务管理效能方面发挥了重要作用,将其用于医政管理有助于制定科学完善的全流程质量管理体系,提高医疗质量管理效率,保障患者安全。作者介绍了上海市某三级综合医院探索建立医院感染防控网格化管理模式的实践。该院自2016年初全面实行网格化管理模式,构建了"院-科-组"三级医院感染防控管理组织架构、科学布置防控管理网格点、施行专人岗位责任制、制定绩效考核体系并实施激励措施。通过描述性分析和 χ2检验分析网格化管理实施前后的医院感染相关数据,结果显示:实施后的医院感染人数、手术部位感染人数、Ⅰ类手术切口感染人数、感染呼吸机相关肺炎人数均低于实施前且实施后呈现逐年下降的趋势;而实施后的治疗性抗菌药物使用前送检人数、发热病人血培养送检人数、手卫生依从时机均高于实施前且实施后呈现逐年上升趋势( P<0.05)。网格化管理模式能够显著降低医院感染风险,提升医院感染管理质量,适用于在医疗机构内运用和推广。
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abstractsGrid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.
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