Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
Objective To explore the clinical effect of failure mode and effect analysis (FMEA) combined with PDCA cycle management model in the prevention and control of multidrug-resistant organisms (MDROs) in intensive care unit (ICU), and provide evidences for drawing up improvement measures in healthcare-associated MDRO infections in ICU. Methods In January 2020, a risk assessment team was established in the Department of Critical Care Medicine, the First People’s Hospital of Longquanyi District of Chengdu, to analyze the possible risk points of MDRO infections in ICU from then on. FMEA was used to assess risks, and the failure modes with high risk priority numbers were selected to evaluate the high-risk points of MDRO infections. The causes of the high-risk points were analyzed, and improvement measures were formulated to control the risks through PDCA cycle management model. The incidence of healthcare-associated MDRO infections in ICU, improvement of high-risk events, and satisfaction of doctors and nurses after the implementation of intervention measures (from January 2020 to June 2021) were retrospectively collected and compared with those before the implementation of intervention measures (from January 2018 to December 2019). Results Six high-risk factors were screened out, namely single measures of isolation, unqualified cleaning and disinfection of bed units, irrational use of antimicrobial agents, weak consciousness of isolation among newcomers of ICU, weak awareness of pathogen inspection, and untimely disinfection. The incidence of healthcare-associated MDRO infections was 2.71% (49/1800) before intervention and 1.71% (31/1808) after intervention, and the difference between the two periods was statistically significant (χ2=4.224, P=0.040). The pathogen submission rate was 56.67% (1020/1800) before intervention and 61.23% (1107/1808) after intervention, and the difference between the two periods was statistically significant (χ2=7.755, P=0.005). The satisfaction rate of doctors and nurses was 75.0% (30/40) before intervention and 95.0% (38/40) after intervention, and the difference between the two periods was statistically significant (χ2=6.275, P=0.012). Conclusions FMEA can effectively find out the weak points in the prevention and treatment of MDRO infections in ICU, while PDCA model can effectively formulate improvement measures for the weak points and control the risks. The combined application of the two modes provides a scientific and effective guarantee for the rational prevention and treatment of MDRO infections in ICU patients.
Objective To investigate the staffing status of full-time personnel for healthcare-associated infection (HAI) management department in secondary or above medical institutions in Yunnan Province, analyze the factors affecting the stability of the HAI workforce, and provide a scientific basis for strengthening the department of HAI professionals and improving the standard of the full-time personnel team. Methods In April 2023, a questionnaire survey was conducted to investigate the staffing status of full-time HAI management department personnel across 394 secondary or above medical institutions in Yunnan Province. Results A total of 394 secondary or above medical institutions were included in this survey. Among the institutions participating in the survey, 393 (99.75%) had established a separate hospital-acquired infection management, and 303 (76.90%) met the requirement of having at least one full-time infection control personnel for every 200 beds. Among the 689 full-time HAI management department practitioners surveyed, the majority were female (94.34%), those aged 41-50 were the largest age group (34.69%), the predominant educational background was a bachelor’s degree (72.42%), the primary specialty was nursing (80.84%), and the most common professional title was intermediate level (36.14%). There were statistically significant differences between the full-time HAI practitioners in secondary medical institutions and those in tertiary medical institutions in educational background (Z=–6.220, P<0.001), specialty (χ2=41.612, P<0.001), professional title (Z=–2.432, P=0.015), and years of engagement (χ2=47.298, P<0.001). There was no statistically significant difference in gender or age (P>0.05). The primary reason for full-time practitioners engaging in HAI work was “following leadership arrangements” (79.97%). Tertiary medical institutions had a significantly higher proportion of full-time HAI management personnel who took up their positions due to “graduation recruitment” or “major matching” than secondary medical institutions (P<0.05), while the proportion of those who entered the field due to “leadership arrangement” was significantly lower than that in secondary medical institutions (P<0.05). In the survey on factors contributing to the instability of the full-time personnel team, the top three factors identified were excessive work pressure, difficulties in professional title promotion, and an overwhelming amount of required learning content. Conclusions There is an insufficient allocation of full-time HAI control personnel in secondary or above medical institutions in Yunnan Province, and the professional composition of this workforce requires greater diversification. The primary factors contributing to the instability of the dedicated personnel team are high work pressure and difficulties in professional title promotion. It is recommended to expedite the improvement of career advancement pathways for HAI control personnel to provide support and guarantees for building a robust full-time infection control workforce.
