中心静脉导管相关血流感染监测质量管理效果研究
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R181.3+2

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重大疾病流行病学教育部重点实验室(北京大学)2024年度开放基金(2024204)


Effect of quality management for central line-associated bloodstream infection surveillance
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    摘要:

    目的 建立标准化的中心静脉导管相关血流感染(CLABSI)监测流程,实施全流程质量管理以提升监测质量为有效防控CLABSI提供依据。方法 通过多学科协作,梳理CLABSI监测全流程,包括血标本培养、置管信息获取及感染诊断存在的问题;针对性开展质量管理干预,干预措施包括统一监测标准、优化置管医嘱、规范血培养采集;比较干预前后系统抓取的置管信息与填报数据的一致性和血培养污染情况的变化,并评价质量管理干预的效果。结果 建立了统一的CLABSI监测流程及中心静脉导管置管医嘱方案。2024年中心静脉置管日数229 439 d, 发生CLABSI 60例次,CLABSI发病率为0.26‰。CLABSI集中发生在血液科、重症监护病房。检出病原菌65株,凝固酶阴性葡萄球菌是CLABSI主要病原菌,占49.23%(32株)。干预后,信息系统按医嘱抓取的置管日数与临床手工填报数据的一致性显著提升,由干预前的61.72%升至干预后的78.18%(P<0.05)。干预前后血培养污染率均维持在较低水平。结论 CLABSI监测的全流程质量管理能够显著提升监测效率和效果。

    Abstract:

    Objective To establish standard surveillance procedure for central line-associated bloodstream infection (CLABSI), implement full-process quality management for improving surveillance quality, and provide basis for effective prevention and control for CLABSI. Methods Through multidisciplinary team management, the entire surveillance process of CLABSI was sorted out, including problems related to culture of blood specimen, capture of catheterization information, and diagnosis of infection. Targeted quality management interventions were carried out. Intervention measures included unifying surveillance standards, optimizing medical orders for catheterization, and standardizing blood culture collection. The consistency between the catheterization information captured by the system and the manually filled data, as well as the changes in blood culture contamination before and after intervention were compared, and the effectiveness of quality management intervention was evaluated. Results A unified CLABSI surveillance process and a scheme of medical order for central venous catheterization (CVC) were established. In 2024, CVC days was 229 439, 60 cases of CLABSI occurred, and the incidence of CLABSI was 0.26 ‰. CLABSI occurred mainly in the department of hematology and intensive care units. 65 strains of pathogenic bacteria were detected, and coagulase negative Staphylococcus was the main pathogen of CLABSI, accounting for 49.23% (n=32). After intervention, the consistency between the number of catheterization days according to medical orders obtained by the information system and the manually filled clinical data significantly improved, from 61.72% before intervention to 78.18% after intervention (P<0.05). The contamination rate of blood culture remained at a low level before and after intervention. Conclusion The full-process quality management of CLABSI surveillance can significantly improve surveillance efficiency and effectiveness.

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陈美恋,陈春梅,王欣心,等.中心静脉导管相关血流感染监测质量管理效果研究[J]. 中国感染控制杂志,2026,25(1):60-67. DOI:10.12138/j. issn.1671-9638.20267404.
CHEN Meilian, CHEN Chunmei, WANG Xinxin, et al. Effect of quality management for central line-associated bloodstream infection surveillance[J]. Chin J Infect Control, 2026,25(1):60-67. DOI:10.12138/j. issn.1671-9638.20267404.

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  • 收稿日期:2025-08-08
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  • 在线发布日期: 2026-01-28
  • 出版日期: 2026-01-28