West China School of Nursing, Sichuan University /Department of Medical Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.
Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
PLoS One. 2023 Nov 16;18(11):e0294606. doi: 10.1371/journal.pone.0294606. eCollection 2023.
In China, studies have shown nosocomial infections contribute to increased mortality rates, prolonged hospital stays, and added financial burdens for patients. Previous studies have demonstrated that effective infection control training can enhance the quality of infection control practices, particularly in intensive care unit (ICU) settings. However, there is currently no universally accepted training mode or program that adequately addresses the specific needs of ICU medical staff regarding nosocomial infection control. The objective of this study was to develop a standardized training system for preventing and controlling hospital-acquired infections among new medical staff in the internal medicine ICU. Our methodology encompassed an extensive literature review, technical interviews focusing on key events, semi-structured in-depth interviews, and two rounds of Delphi expert correspondence. We employed intentional sampling to select 16 experts for the Delphi expert consultation. Indicators were chosen based on an average importance score of >3.5 and a coefficient of variation of <0.25. The weight of each indicator was determined using the analytic hierarchy process. The efficacy of the two rounds of questionnaires was also evaluated. Our findings revealed that the questionnaires achieved a 100% effective recovery rate, with expert authority coefficients of 0.96 and 0.90. The Kendall coordination coefficients for the first-, second-, and third-level indicators in the initial round of expert consultation questionnaires were 0.440, 0.204, and 0.386 (P < 0.001), respectively. In the second round of expert consultation questionnaires, the Kendall coordination coefficients for the first, second, and third-level indicators were 0.562, 0.467, and 0.556 (P < 0.001), respectively. The final training model consisted of four first-level indicators (hospital infection prevention and control training content, training methods/forms, assessment content, and evaluation indicators), 26 second-level indicators, and 44 third-level indicators. In conclusion, the proposed standardized training system for infection prevention and control among new medical staff in the internal medicine ICU is both scientifically sound and practical, which can contribute to improved patient safety, reduced healthcare costs, and enhanced overall quality of care in internal medicine ICUs. Moreover, it can serve as a framework for future training projects.
在中国,研究表明医院感染会导致死亡率升高、住院时间延长和患者经济负担加重。先前的研究表明,有效的感染控制培训可以提高感染控制实践的质量,特别是在重症监护病房(ICU)环境中。然而,目前还没有普遍接受的培训模式或方案能够充分满足 ICU 医务人员对医院感染控制的特定需求。本研究的目的是为内科 ICU 新入职医务人员制定一套标准化的医院感染预防与控制培训体系。我们的方法包括广泛的文献回顾、针对关键事件的技术访谈、半结构化深入访谈以及两轮德尔菲专家函询。我们采用立意抽样选择了 16 名专家进行德尔菲专家咨询。指标的选择基于平均重要性评分>3.5 和变异系数<0.25。采用层次分析法确定各指标的权重。还评估了两轮问卷的效果。我们的研究结果表明,问卷的有效回收率达到了 100%,专家权威系数分别为 0.96 和 0.90。在第一轮专家咨询问卷的一级、二级和三级指标的肯德尔协调系数分别为 0.440、0.204 和 0.386(P<0.001)。在第二轮专家咨询问卷中,一级、二级和三级指标的肯德尔协调系数分别为 0.562、0.467 和 0.556(P<0.001)。最终的培训模型包括四个一级指标(医院感染预防与控制培训内容、培训方法/形式、考核内容、评价指标)、26 个二级指标和 44 个三级指标。总之,本研究提出的内科 ICU 新入职医务人员感染预防与控制标准化培训体系科学实用,有助于提高患者安全、降低医疗成本和提高内科 ICU 的整体护理质量。此外,它可以作为未来培训项目的框架。