Sekimoto Miho, Imanaka Yuichi, Kobayashi Hiroyoshi, Okubo Takashi, Kizu Junko, Kobuse Hiroe, Mihara Hanako, Tsuji Noriaki, Yamaguchi Ayumi
Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan.
Am J Infect Control. 2009 Mar;37(2):136-42. doi: 10.1016/j.ajic.2008.03.005.
In Japan, hospital infection control (IC) programs are frequently underresourced, and their improvement is considered a pressing issue.
In 2005, we conducted a questionnaire survey of 638 teaching hospitals (most with 300 or more beds) and 882 nonteaching hospitals (most with fewer than 300 beds) in Japan. We analyzed associations among resources, infrastructures, activities, and performance related to IC.
A total of 423 teaching hospitals (66.3%) and 377 nonteaching hospitals (50.2%) responded to the survey. The teaching hospitals had more IC infrastructure, such as full-time infection control practitioners (ICPs), link nurses, and infection control teams (ICTs), compared with the nonteaching hospitals. Infection surveillance was more likely to be implemented in hospitals with more ICP full-time equivalents (FTEs). IC performance scores were significantly higher in the teaching hospitals than in the nonteaching hospitals. In multivariate analyses, greater IC infrastructure, such as ICP FTEs, full-time IC nurses, and regular ICT rounds were significantly associated with IC performance. Hospital accreditation and hospital size also were significantly associated with higher IC performance scores.
Given the strong associations found among IC infrastructure and performance, a new framework for evaluating IC infrastructure and for providing financial support may be effective in enhancing IC programs.
在日本，医院感染控制（IC）项目的资源常常不足，其改进被视为一个紧迫问题。
2005年，我们对日本的638家教学医院（多数床位在300张及以上）和882家非教学医院（多数床位少于300张）进行了问卷调查。我们分析了与感染控制相关的资源、基础设施、活动和绩效之间的关联。
共有423家教学医院（66.3%）和377家非教学医院（50.2%）回复了调查。与非教学医院相比，教学医院拥有更多的感染控制基础设施，如全职感染控制从业人员（ICP）、联络护士和感染控制团队（ICT）。在全职等效感染控制从业人员（FTE）更多的医院，感染监测更有可能得以实施。教学医院的感染控制绩效得分显著高于非教学医院。在多变量分析中，更多的感染控制基础设施，如感染控制从业人员全职等效人数、全职感染控制护士以及感染控制团队定期巡查，与感染控制绩效显著相关。医院认证和医院规模也与更高的感染控制绩效得分显著相关。
鉴于在感染控制基础设施与绩效之间发现的紧密关联，一个用于评估感染控制基础设施并提供财政支持的新框架可能在加强感染控制项目方面有效。
