强化医院领导在感染控制中的作用（LEAD-IC）-德国急性护理医院的多模式教育干预。

Strengthening the role of hospital leadership in infection control (LEAD-IC) - a multimodal educational intervention in German acute care hospitals.

机构信息

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Institute of Hygiene and Environmental Medicine, Berlin, Germany.

National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.

出版信息

BMC Med Educ. 2023 Oct 11;23(1):758. doi: 10.1186/s12909-023-04709-z.

DOI:10.1186/s12909-023-04709-z

PMID:37821838

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10568750/

Abstract

BACKGROUND

The effect of leadership support for adherence to infection control and prevention (IPC) measures has been demonstrated. To expand this support, a target group-specific educational study for chief medical officers (CMO) was implemented and its influence on IPC indicators was investigated.

METHODS

A controlled cohort study was conducted between 2018 and 2019. The intervention based on an initial workshop, an e-learning course, and a final meeting. Participants' activities involving IPC management were surveyed. Consumption of alcohol hand rub (AHR) and incidence density of hospital-associated (HA) Clostridioides difficile-associated infections (CDI) were analyzed.

RESULTS

Eight percent of 360 CMOs invited participated in the initial workshop; 70% of those participants registered for the online course. Overall, 43% completed the post-intervention questionnaire, in which 85% of respondents reported increased collaboration with relevant stakeholders. The pre-intervention median AHR consumption was higher in the intervention group than in the control group. Both groups showed an increase (38.6 (interquartile range (IQR) 33.6; 45.0) to 41.9 ml/patient day (PD) (IQR 35.0; 56.6) and 33.4 (IQR 28.3; 40.8) to 35.8 ml/ PD (IQR 31.6; 43.2), respectively). Pre-intervention median HA CDI cases were lower in the intervention group than in the control group. Both groups reported a decrease (0.22 (IQR 0.17; 0.33) to 0.19 cases/1000 PD (IQR 0.15; 0.26) and 0.32 (IQR 0.2; 0.48) to 0.22 cases/1000 PD (IQR 0.11; 0.33), respectively).

CONCLUSION

Multimodal IPC training of CMOs is worthwhile and can lead to changes in IPC-relevant cooperation in hospitals. IPC training of hospital management should be further intensified.

摘要

背景

领导力对遵守感染控制和预防（IPC）措施的支持效果已得到证实。为了扩大这种支持，针对首席医疗官（CMO）实施了一项针对特定目标群体的教育研究，并调查了其对 IPC 指标的影响。

方法

本研究采用对照队列研究，于 2018 年至 2019 年进行。该干预措施基于初始研讨会、在线学习课程和最终会议。调查参与者参与 IPC 管理的活动。分析酒精擦手液（AHR）的消耗量和医院相关（HA）艰难梭菌相关感染（CDI）的发病率密度。

结果

360 名受邀的 CMO 中，有 8%参加了初始研讨会；其中 70%的参与者注册了在线课程。共有 43%的人完成了干预后的问卷调查，其中 85%的受访者报告称与相关利益攸关方的合作有所增加。干预组的 AHR 消耗量在干预前高于对照组。两组均有所增加（38.6（四分位距（IQR）33.6；45.0）至 41.9 ml/患者天（PD）（IQR 35.0；56.6）和 33.4（IQR 28.3；40.8）至 35.8 ml/PD（IQR 31.6；43.2））。干预前，HA CDI 病例在干预组中低于对照组。两组均有所下降（0.22（IQR 0.17；0.33）至 0.19 例/1000 PD（IQR 0.15；0.26）和 0.32（IQR 0.2；0.48）至 0.22 例/1000 PD（IQR 0.11；0.33））。