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评估全球护理干预措施对减少医院获得性感染的影响：一项荟萃分析。

Assessing Global Nursing Interventions in Reducing Hospital-Acquired Infections: A Meta-Analysis.

作者信息

Ye Fuping, Ma Lingfei

机构信息

Department of Gastrointestinal Surgery, Jiaozhou Central Hospital of Qingdao, No.99, Yunxi Henan Road, Jiaozhou, Qingdao, 266300, China.

Department of Nursing, Jiaozhou Central Hospital Of Qingdao, No.99, Yunxi Henan Road, Jiaozhou, Qingdao, 266300, China.

出版信息

Iran J Public Health. 2025 May;54(5):915-927. doi: 10.18502/ijph.v54i5.18627.

DOI:10.18502/ijph.v54i5.18627
PMID:40765793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12319439/
Abstract

BACKGROUND

Hospital-acquired infections (HAIs) raise worldwide morbidity, death, and healthcare expenditures. Preventing and managing HAIs requires nursing interventions such hand hygiene, personal protective equipment (PPE) usage, environmental cleaning, and antimicrobial stewardship. This meta-analysis examined how nursing interventions reduced HAIs in different hospital settings.

METHODS

A complete PubMed, Scopus, and Web of Science search was undertaken for January 2000-December 2023 research. Studies on HAI-reducing nursing interventions were included. Study quality was evaluated using the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. The random-effects model was used to construct pooled risk ratios (RRs) with 95% CIs in meta-analysis. We also performed subgroup, sensitivity, and publication bias analyses.

RESULTS

Fourteen trials with 2540 individuals were included. In the pooled study, nursing interventions significantly reduced HAI incidence (RR = 0.42, 95% CI: 0.35-0.50, < 0.001). Subgroup analysis indicated that hand hygiene, PPE usage, environmental cleaning, and antimicrobial stewardship reduced HAIs. Sensitivity analysis verified these results' reliability. Egger's test showed no publication bias ( = 0.78). Over time, cumulative meta-analysis showed constant effect sizes.

CONCLUSION

Nursing interventions significantly reduce HAIs. Hand hygiene, PPE, environmental cleaning, and antimicrobial stewardship are essential to infection control. Healthcare institutions should prioritise these actions and resolve compliance hurdles to enhance patient outcomes and minimise HAIs. Research is needed to explore innovative approaches and identify factors influencing compliance.

摘要

背景

医院获得性感染（HAIs）在全球范围内增加了发病率、死亡率和医疗保健支出。预防和管理医院获得性感染需要护理干预措施，如手卫生、个人防护装备（PPE）的使用、环境清洁和抗菌药物管理。这项荟萃分析研究了护理干预措施如何在不同医院环境中减少医院获得性感染。

方法

对2000年1月至2023年12月的研究进行了全面的PubMed、Scopus和科学网搜索。纳入了关于减少医院获得性感染的护理干预措施的研究。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表评估研究质量。在荟萃分析中，采用随机效应模型构建合并风险比（RRs）及95%置信区间（CIs）。我们还进行了亚组分析、敏感性分析和发表偏倚分析。

结果

纳入了14项试验，共2540名个体。在汇总研究中，护理干预措施显著降低了医院获得性感染的发生率（RR = 0.42，95% CI：0.35 - 0.50，P < 0.001）。亚组分析表明，手卫生、PPE的使用、环境清洁和抗菌药物管理降低了医院获得性感染。敏感性分析验证了这些结果的可靠性。Egger检验显示无发表偏倚（P = 0.78）。随着时间的推移，累积荟萃分析显示效应量恒定。

结论

护理干预措施显著降低了医院获得性感染。手卫生、PPE、环境清洁和抗菌药物管理对感染控制至关重要。医疗机构应优先采取这些措施并解决依从性障碍，以改善患者预后并最大限度减少医院获得性感染。需要开展研究以探索创新方法并确定影响依从性的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/0c7f5cb6e787/IJPH-54-915-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/134481e4fa2c/IJPH-54-915-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/dea2ff563239/IJPH-54-915-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/e5ccc6fe4b15/IJPH-54-915-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/0ece7e99c9b9/IJPH-54-915-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/0c7f5cb6e787/IJPH-54-915-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/134481e4fa2c/IJPH-54-915-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/dea2ff563239/IJPH-54-915-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/e5ccc6fe4b15/IJPH-54-915-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/0ece7e99c9b9/IJPH-54-915-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e07d/12319439/0c7f5cb6e787/IJPH-54-915-g005.jpg

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