Реферат
Objective To construct a quantitative evaluation system for professional competency of healthcare-associated infection(HAI)management professionals,and provide scientific basis for the training of professionals through scientific evaluation.Methods Literature and experience summary were adopted to construct evaluation key points.Evaluation key points were selected through expert consultation method,and the weight coefficient of evaluation key points was calculated.The hierarchical evaluation content options for each evaluation key point were designed and assigned score values by expert group.The product of the score of each evaluation key point and its weight was the score for this point,and the total score of the evaluated person was calculated based on the total score of all evaluation points.Results The evaluation system included 25 evaluation key points in 9 dimensions,in-cluding"basic conditions""recognition competency in HAI""monitoring competency in HAI""prevention and con-trol technology application competency in HAI""emergency response competency""organization and coordination competency""quality improvement competency""education and training competency"and"professional scientific re-search competency in HAI prevention and control".Each evaluation key point contained three hierarchical quantita-tive score contents.The internal consistency reliability of the expert's questionnaire consultation Cronbach's a coef-ficient was 0.873,the total scale-level content validity index(S-CVI)was 0.868,and the item-level content validity index(I-CVI)ranged 0.71-1.Conclusion The quantitative evaluation system constructed in this study meets the requirements for reliability and validity.It is scientifically feasible for evaluating the professional competency of HAI management professionals.It can effectively identify weakness in their competency,determine training directions and priorities,and provide a scientific basis for talent development and team building for HAI management profe-ssionals in medical institutions,and promotes high-quality development within hospitals.
Реферат
Objective To establish the risk prediction scoring model of central line-associated bloodstream infection (CLABSI) in elderly patients, provide basis for screening high-risk population, and effectively prevent and control bloodstream infection (BSI) in elderly patients.Methods According to the inclusion and exclusion criteria, data of elderly patients who underwent central catheterization during hospitalization from January 1, 2015 to December 31, 2017 were collected, patients were randomly divided into modeling group and verification group according to the ratio of 7∶3 (random seed was 20180708), risk factors of data of modeling group were distinguished, logistic regression model was constructed. The corresponding score of each risk factor was assigned according to β value, infection risk scoring model was established, prediction accuracy of model was evaluated by receiver operating characteristic (ROC) curve; according to the established infection risk scoring model, cases in validation group were scored, prediction accuracy of model was evaluated by ROC curve. Decision curve was constructed using R software.Results Logistic regression analysis showed that the number of operation≥3 times, length of stay in intensive care unit (ICU) ≥2 days, duration of indwelling central venous catheterization≥7 days, and use of antimicrobial agents were independent risk factors for CLABSI in elderly patients; the corresponding points in risk prediction scoring model were 3, 4, 4, and 9 respectively, and the score of 13-17 points were high-risk population of CLABSI; the area of ROC curve (AUC) was 0.74 in the modeling group; ROC curve was plotted based on the risk score of patients in validation group, AUC was 0.70. The decision curve showed that the net benefit of the risk scoring model was higher in the high risk thershold of 0.01-0.05.Conclusion The established risk prediction scoring model has good discriminant validity and application value, and can be used in the identification of susceptible high risk population of CLABSI in elderly patients, so as to achieve early prevention and control.