Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland.
Laboratory of Epidemiology, Military Institute of Hygiene and Epidemiology (WIHE), 01-163 Warsaw, Poland.
Int J Environ Res Public Health. 2021 Dec 31;19(1):441. doi: 10.3390/ijerph19010441.
Infections with multi-drug resistant microorganisms associated with the provision of health services have become an acute problem worldwide. These infections cause increased morbidity as well as mortality and are a financial burden for the healthcare system. Effective risk management can reduce the spread of infections and thus minimize their number in hospitalized patients. We have developed a new approach to the analysis of hazards and of exposure to the risk of adverse events by linking the patient's health record system to the entire infrastructure of the hospital unit. In this study, using the developed model, we focused on infections caused by the bacterium, as they constitute a significant number of nosocomial infections in Poland and worldwide. The study was conducted in a medical facility located in the central part of Poland which provides tertiary care. In the proposed PM model, a risk analysis of hospital acquired infections at the Intensive Care and Anesthesiology Unit combined with the hospital's technical facilities and organizational factors was conducted. The obtained results indicate the most critical events which may have an impact on potential hazards or risks which may result from the patient's stay at the specific ward. Our method can be combined with an anti-problem approach, which minimizes the critical level of infection in order to determine the optimal functioning of the entire hospital unit. Research has shown that in most situations the spread dynamics of nosocomial infections can be controlled and their elimination may be attempted. In order to meet these conditions, the persons responsible for the daily operation of the medical facility and its individual wards have to indicate potential events and factors which present a risk to the hospitalized patients. On the basis of a created spreadsheet directions for improvement may be finally established for all potential events, their frequency may be minimized, and information may be obtained on actions which should be undertaken in a crisis situation caused by the occurrence of a given phenomenon. We believe that the proposed method is effective in terms of risk reduction, which is important for preventing the transmission of multi-drug resistant microorganisms in the hospital environment.
与医疗服务提供相关的多重耐药微生物感染已成为全球范围内的一个严重问题。这些感染会导致发病率和死亡率上升，并给医疗保健系统带来经济负担。有效的风险管理可以减少感染的传播，从而最大限度地减少住院患者中的感染数量。我们开发了一种新方法，通过将患者的健康记录系统与医院单元的整个基础设施联系起来，来分析危害和不良事件风险的暴露情况。在这项研究中，我们使用所开发的模型，重点关注由细菌引起的感染，因为它们在波兰和全球范围内构成了大量的医院获得性感染。该研究在波兰中部的一家提供三级护理的医疗机构进行。在所提出的 PM 模型中，对重症监护和麻醉学病房的医院获得性感染进行了风险分析，同时考虑了医院的技术设施和组织因素。获得的结果表明，最关键的事件可能会对潜在危害或风险产生影响，这些危害或风险可能是由于患者在特定病房停留而产生的。我们的方法可以与反问题方法相结合，从而将感染的临界水平降至最低，以确定整个医院单元的最佳运行。研究表明，在大多数情况下，可以控制医院获得性感染的传播动态，并可以尝试消除它们。为了满足这些条件，负责医疗机构及其各个病房日常运营的人员必须指出对住院患者构成风险的潜在事件和因素。基于创建的电子表格，可以为所有潜在事件制定改进方向，使它们的频率最小化，并获取有关在发生特定现象导致的危机情况下应采取的行动的信息。我们相信，所提出的方法在降低风险方面是有效的，这对于防止医院环境中多重耐药微生物的传播非常重要。
