1.Trend changes of healthcare-associated infection in intensive care unit:an analysis based on Joinpoint regression model from 2012 to 2023
Yinzhi CHEN ; Zailan TU ; Mingchuan ZHOU ; Hemei YE ; Zhen ZHONG ; Yan CHENG ; Xiaoyan LIU ; Zhangmei HOU
Chinese Journal of Infection Control 2025;24(5):657-665
Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84% and 9.45%,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17%.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63%and 90.46%,respectively.From 2012 to 2023,incidence of HAI(51.29%vs 4.39%),case incidence of HAI(72.41%vs 4.94%),the adjusted incidence of HAI(15.98%vs 1.04%),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P<0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00%vs 90.28%)increased significantly(both P<0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30% vs 9.57%)and a decrease in the proportion of fungi(11.04%vs 1.74%).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P<0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P<0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.
2.Trend changes of healthcare-associated infection in intensive care unit:an analysis based on Joinpoint regression model from 2012 to 2023
Yinzhi CHEN ; Zailan TU ; Mingchuan ZHOU ; Hemei YE ; Zhen ZHONG ; Yan CHENG ; Xiaoyan LIU ; Zhangmei HOU
Chinese Journal of Infection Control 2025;24(5):657-665
Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84% and 9.45%,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17%.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63%and 90.46%,respectively.From 2012 to 2023,incidence of HAI(51.29%vs 4.39%),case incidence of HAI(72.41%vs 4.94%),the adjusted incidence of HAI(15.98%vs 1.04%),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P<0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00%vs 90.28%)increased significantly(both P<0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30% vs 9.57%)and a decrease in the proportion of fungi(11.04%vs 1.74%).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P<0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P<0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.
3.Application effect of biofeedback electrical stimulation combined with vaginal hysterectomy in elderly patients with pelvic organ prolapse
Wenqiao MA ; Haibo WANG ; Ping LI ; Xiaoli HU ; Chunyuan DU ; Yanfang NING ; Rongxian LI ; Yinzhi ZHEN
Chinese Journal of Endocrine Surgery 2024;18(6):903-908
Objective:To explore the application effect of biofeedback functional electrical stimulation (BF-FES) combined with vaginal hysterectomy (TVH) in elderly patients with pelvic organ prolapse (POP) .Methods:A prospective study was conducted on 92 elderly POP patients admitted to the hospital from Jul. 2020 to Dec. 2022. They were divided into a study group (45 cases) and a control group (47 cases) using a random number table method. The control group received TVH treatment and underwent routine pelvic floor rehabilitation training after surgery; The research group received BF-FES treatment on the basis of the control group. All patients were treated continuously for 4 weeks and followed up for 6 months. The surface electromyographic values, three-dimensional pelvic floor ultrasound parameters, and urodynamic indicators between the two groups were compared before treatment and at 4 weeks of treatment. The results of the 1-hour urinary pad test before treatment, at 4 weeks of treatment, and at 3 and 6 months of follow-up were compared.Results:The surface electromyographic values of the two groups of patients at each stage of treatment for 4 weeks were higher than those before treatment. The surface electromyographic values of the study group at rest, rapid contraction, tense contraction, endurance contraction, and post rest stages were higher than those of the control group ( P<0.05). After 4 weeks of treatment, the mobility of the bladder neck in both groups was higher than those before treatment, while the posterior angle and rotation angle of the urethra and bladder were lower than those before treatment; The mobility of the bladder neck in the study group was higher than that in the control group, while the posterior angle of the urethra and bladder, as well as the rotation angle of the urethra were lower than those of the control group ( P<0.05). The maximum urine flow rate, maximum bladder volume, and average urine flow rate of the two groups after 4 weeks of treatment were higher than those before treatment, while residual urine volume was lower than that before treatment; The maximum urine flow rate, maximum bladder volume, and average urine flow rate in the study group were were higher than those in the control group. The residual urine volume in the observation group was lower than that in the control group ( P<0.05). After 4 weeks of treatment, 3 months of follow-up, and 6 months of follow-up, the increase in 1-hour urine pad weight of patients in the two groups gradually decreased compared to that before treatment, and the study group was lower than the control group ( P<0.05) . Conclusion:BF-FES combined with TVH can significantly enhance pelvic muscle strength, improve pelvic floor ultrasound parameters and urodynamic indicators in elderly POP patients, and have a significant effect on treating urinary incontinence in patients.
4.Application effect of biofeedback electrical stimulation combined with vaginal hysterectomy in elderly patients with pelvic organ prolapse
Wenqiao MA ; Haibo WANG ; Ping LI ; Xiaoli HU ; Chunyuan DU ; Yanfang NING ; Rongxian LI ; Yinzhi ZHEN
Chinese Journal of Endocrine Surgery 2024;18(6):903-908
Objective:To explore the application effect of biofeedback functional electrical stimulation (BF-FES) combined with vaginal hysterectomy (TVH) in elderly patients with pelvic organ prolapse (POP) .Methods:A prospective study was conducted on 92 elderly POP patients admitted to the hospital from Jul. 2020 to Dec. 2022. They were divided into a study group (45 cases) and a control group (47 cases) using a random number table method. The control group received TVH treatment and underwent routine pelvic floor rehabilitation training after surgery; The research group received BF-FES treatment on the basis of the control group. All patients were treated continuously for 4 weeks and followed up for 6 months. The surface electromyographic values, three-dimensional pelvic floor ultrasound parameters, and urodynamic indicators between the two groups were compared before treatment and at 4 weeks of treatment. The results of the 1-hour urinary pad test before treatment, at 4 weeks of treatment, and at 3 and 6 months of follow-up were compared.Results:The surface electromyographic values of the two groups of patients at each stage of treatment for 4 weeks were higher than those before treatment. The surface electromyographic values of the study group at rest, rapid contraction, tense contraction, endurance contraction, and post rest stages were higher than those of the control group ( P<0.05). After 4 weeks of treatment, the mobility of the bladder neck in both groups was higher than those before treatment, while the posterior angle and rotation angle of the urethra and bladder were lower than those before treatment; The mobility of the bladder neck in the study group was higher than that in the control group, while the posterior angle of the urethra and bladder, as well as the rotation angle of the urethra were lower than those of the control group ( P<0.05). The maximum urine flow rate, maximum bladder volume, and average urine flow rate of the two groups after 4 weeks of treatment were higher than those before treatment, while residual urine volume was lower than that before treatment; The maximum urine flow rate, maximum bladder volume, and average urine flow rate in the study group were were higher than those in the control group. The residual urine volume in the observation group was lower than that in the control group ( P<0.05). After 4 weeks of treatment, 3 months of follow-up, and 6 months of follow-up, the increase in 1-hour urine pad weight of patients in the two groups gradually decreased compared to that before treatment, and the study group was lower than the control group ( P<0.05) . Conclusion:BF-FES combined with TVH can significantly enhance pelvic muscle strength, improve pelvic floor ultrasound parameters and urodynamic indicators in elderly POP patients, and have a significant effect on treating urinary incontinence in patients.

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