Wilbrandt B, Wischnewski N, Geffers C, Daschner F, Rüden H, Gastmeier P
Krankenhaus Berlin-Lichtenberg.
Zentralbl Chir. 2001 Sep;126(9):691-5. doi: 10.1055/s-2001-18244.
In the framework of a prospective controlled study in surgical and intensive care units of four study and four control hospitals it was tried to set up an infection control quality management concept for reduction of nosocomial infections in hospital D. With an incidence density of 5.4 nosocomial infections per 1,000 patient days the most favorable situation among the four study hospitals was found initially in this hospital. However, after a small decrease of infection rate during the first study year, no benefit of intervention was achieved in this hospital at the end of the study (6.4 nosocomial infections per 1,000 patient days). Possible explanations may be a very small potential for reduction at the beginning, a change of patient mix due to a new head of the department and the phenomenon of the "regression to the mean". Distinct improvements of the situation were achieved on the level of process quality. Meanwhile surveillance of nosocomial infections became an integral part of quality management in this hospital. The quality circle method was not well accepted for the longterm. But the concept of link nurses was introduced successfully.
在四家研究医院和四家对照医院的外科及重症监护病房开展的一项前瞻性对照研究框架内，试图为D医院建立一个感染控制质量管理概念，以减少医院内感染。该医院最初在四家研究医院中处于最有利的情况，每1000个患者日的医院内感染发病率为5.4例。然而，在第一个研究年度感染率略有下降之后，在研究结束时该医院未实现干预效益（每1000个患者日有6.4例医院内感染）。可能的解释包括一开始降低感染率的潜力非常小、科室新主任导致患者组合发生变化以及“向均值回归”现象。在过程质量层面取得了明显的改善。与此同时，医院内感染监测成为该医院质量管理的一个组成部分。质量圈方法长期未被很好地接受。但成功引入了联络护士概念。
