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细菌真菌感染诊治培训项目效果评价及建议
发布人：yaot 发布时间：2023/2/1 11:29:08 浏览次数：896次
——孙晓宇 马丽平 李娜 杨威 刘倩楠 熊康 吴奇飞
【摘要】目的 了解细菌真菌感染诊治培训项目对医疗机构感染学科建设的影响。方法 对参与培训项目的805所医疗机构及2 079名学员进行调查，应用Excel 2019软件对收集数据进行整理，应用SPSS 25.0软件进行统计学分析。结果 培训后设有感染科/传染科、细菌真菌感染病区或医疗组、感染/传染门诊、细菌真菌感染门诊的二级及以上综合医院数量均较培训前显著增加（P＜0.001）。医师月均细菌真菌感染专科门诊出诊次数（t=-2.31，P=0.010）和年会诊例次数（t=-4.73，P＜0.001）增加，人均管理床位数也呈增长趋势。9.19%的学员职位转变为抗菌药物管理工作小组组员，5.39%的学员成为组长；1.59%的学员成为院感科主任；9.91%的学员成为省市级讲者，1.59%学员成为全国级讲者。结论 细菌真菌感染诊治培训项目提高了医疗机构对感染科建设的重视程度，符合政策层面对细菌真菌诊疗工作体系建设的要求。未来应进一步加强政策扶持，推动省级层面方案落地，并扩展培训范围。
【关键词】细菌真菌感染；抗菌药物管理；培训项目；效果评价
中图分类号：R197.323；R9文献标识码：A
Effect Evaluation and Suggestion of Training Program on Diagnosis and Treatment of Bacterial and Fungal Infections/SUN Xiaoyu,MA Liping,LI Na,et al.//Chinese Health Quality Management，2022,29(12):29-33
Abstract Objective To investigate the effect of training program on diagnosis and treatment of bacterial and fungal infections on infection discipline construction in medical institutions.Methods A total of 805 medical institutions and 2 079 trainees participating in the training program were investigated. Excel 2019 software was used to sort out the collected data, and SPSS 25.0 software was used for statistical analysis.Results After the training, the number of secondary and above general hospitals with infection department /communicable department, bacterial and fungal infection ward or medical group, infection /communicable clinic, bacterial and fungal infection clinic increased significantly compared with those before the training (P<0.001). The number of outpatient visits (t=-2.31, P=0.010) and annual consultation cases (t=-4.73, P<0.001) increased, and the number of tube beds per capita also showed an increasing trend. 9.19% of the trainees became members of the antimicrobial management working group, and 5.39% became team leaders. 1.59% of the trainees were the director of the hospital's infection department.9.91% of the students proposed to be provincial and municipal continuing education speakers, and 1.59% of the students proposed to be national speakers. Conclusion The training program of diagnosis and treatment of bacterial and fungal infections can improve the attention of medical institutions to the construction of infection department, and meet the requirements of the construction of the system of diagnosis and treatment of bacterial and fungal infections at the policy level. In the future, policy support should be further strengthened to promote the implementation of programs at the provincial level and broaden the scope of training.
Key words Bacterial and Fungal Infections;Antimicrobial Stewardship;Training Program;Effect Evaluation
Firstauthor's address National Institute of Hospital Administration, National Health Commission,Beijing,100044, China
细菌耐药已成为威胁全球公共卫生安全的因素之一。目前，全球每年因耐药性感染死亡人数可达70万以上［1］，我国抗生素的生产量和人均消耗量也远高于美国等发达国家［2］，且基层医疗机构普遍存在抗菌药物使用不合理情况［3］。为加强我国医疗机构细菌真菌感染诊治能力建设，原国家卫生计生委办公厅印发《关于提高二级以上综合医院细菌真菌感染诊疗能力的通知》［4］，要求二级以上综合医院高度重视细菌真菌诊疗工作，并提出加强细菌真菌感染诊疗体系建设，加强感染科人员配备及相关学科建设等5项要求。
国家卫生健康委医院管理研究所于2015年启动“细菌真菌感染诊治培训项目”（培元项目），旨在培养一批青年骨干，形成专业的细菌真菌感染诊治队伍，提高我国感染病诊治及抗菌药物合理使用水平。本研究比较分析了医疗机构和学员参加培元项目前后的变化情况，评价培训效果，旨在为建立和完善细菌真菌感染诊疗体系，促进医疗机构感染科发展提供建议。
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