Objective:To evaluate the effectiveness of internal control of government procurement at public hospitals.Methods:Literature review and Delphi method were used to construct the internal control evaluation index system of government procurement at public hospitals, and the weight of the index system was determined by analytic hierarchy process. The index system was used to evaluate the internal control of government procurement in Hospital Z.Results:The evaluation index system of government procurement internal control of public hospitals covers all aspects of the whole process of government procurement, including 2 level-1 indexes of government procurement internal control unit level and government procurement internal control business level, 11 level-2 indexes and 27 level-3 indexes. The internal control of government procurement of Hospital Z was evaluated with an evaluation score of 81.37 points, an evaluation result relatively effective.Conclusions:The evaluation index system of government procurement internal control of public hospitals constructed in this study could quantitatively evaluate the effectiveness of each sector of government procurement internal control of public hospitals. It could meet the basic evaluation requirements of internal control of government procurement at public hospitals.

BACKGROUNDColonization with methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for subsequent invasive MRSA infection, particularly in patients admitted for critical care. The purpose of this study was to investigate the risk factors affecting nasal colonization of MRSA in patients admitted to intensive care units (ICU).

METHODSBetween August 1, 2011 and June 30, 2012, we screened for MRSA nasal colonization in 350 patients by Real-time PCR within 24 hours of admission by means of swab samples taken from the anterior nares. According to the results of PCR, the patients were divided into 2 groups: the positive group with nasal MRSA colonization and the negative group without nasal MRSA colonization. The 31 (8.86%) patients were MRSA positive. The risk factors evaluated included thirteen variables, which were analyzed by t test for continuous variables and χ(2) test for discrete variables. The variables with significance (P < 0.05) were analyzed with stepwise Logistic regression.

RESULTSThere were differences (P < 0.05) in four variables between two groups. The duration of stay in hospital prior to ICU admission in the positive group was (35.7 ± 16.1) days, vs. (4.5 ± 3.1) days in the negative group. The average blood albumin level was (28.4 ± 2.9) g/L in the positive group, vs. (30.5 ± 4.3) g/L in the negative group. Of 31 patients in the positive group, seven had been treated with antibiotics longer than seven days vs. 34 of 319 patients in the negative group. In the positive group, four of 31 patients received treatment with more than two classes of antibiotics prior to admission in ICU, contrasted to 13 of 319 patients in the negative group. Furthermore, stepwise Logistic regression analysis for these four variables indicates that the duration of stay in hospital prior to ICU admission may be an independent risk factor.

CONCLUSIONSMRSA colonization in ICU admission may be related to many factors. The duration of stay in hospital prior to ICU admission is an independent risk factor.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Female ; Humans ; Intensive Care Units ; Male ; Methicillin-Resistant Staphylococcus aureus ; pathogenicity ; Middle Aged ; Nasal Cavity ; microbiology ; Polymerase Chain Reaction ; Risk Factors ; Staphylococcal Infections ; drug therapy ; Young Adult