医院感染的发生，不仅会加重病情，影响治疗效果，还会延长患者的住院天数，更会加重患者的经济负担，容易引发医疗纠纷，医院感染严重威胁医疗质量与病人安全。由于缺乏经济效益和社会效益的双重动力，我国医院感染管理普遍存在着机制不健全、领导不重视、对院感防控基础设施投入缺乏，基层医务人员对院感防控认识不足、措施执行不到位等诸多问题。在新的诊疗技术不断开展、易感人群连续增加、多重耐药菌持续传播的新形势下，探讨如何构建干预方案，做好医院感染预防与控制，具有重要的现实意义。 本文以福建省某县级二甲综合医院为研究对象，综合运用回顾性调查、半结构化访谈法（n=5）、头脑风暴法（n=5）和前瞻干预等多种研究方法，通过医院感染流行病学研究分析医院感染情况及识别相关的危险因素，在深入调查医院感染管理现状的基础上构建一套切实可行的干预方案，并对干预方案实施效果进行评价和总结，以期为医院进一步加强医院感染预防和控制工作提供相关的实践经验，也为医院构建一套行之有效的干预方案提供一定的理论借鉴，通过研究得出以下结论： 1.医院感染发生率为3.48%，漏报率为2.98%，其中感染率最高的科室为ICU病房，下呼吸道和泌尿道是感染率最高的感染部位。医院感染的危险因素包括年龄段（老年）、住院天数、做手术、使用中心静脉插管、使用尿管插管、使用呼吸机，其中≥13天住院天数是最主要的危险因素。 2.在分析医院感染管理现状的基础上，按照切实可行的原则构建了干预方案，包括医院感染易感人群筛查表、普遍性干预措施和针对性干预措施三个维度，体现了预防为主的理念，强调了手卫生、护理管理和感染监测信息系统对于防控医院感染的重要性。 3.干预方案的实施，在整体上改善了医院感染的状况，降低了医院感染法发生率、漏报率，降低了重点科室的感染率、降低了主要危险因素的感染率，差异具有统计学上的意义（显著性水平α=0.1），达成了预期目标，但未实现降低一般科室感染率、降低下呼吸道感染率的次要目标，需要在分析原因的基础上进一步改进干预方案。
The occurrence of nosocomial infection will aggravate state of illness, affect the treatment result, prolong the patient's hospitalization days, and increase the economic burden on the patient, which will be easy to cause medical disputes. Nosocomial infection seriously threatens the medical quality and patient safety. Due to the lack of two aspects of power from economic benefits and social benefits, there are many problems in the management of nosocomial infection, such as unsound mechanism, lack of leadership value, lack of infrastructure support for nosocomial infection prevention and control. Besides, grassroots medical staffs do not know enough about the prevention and control of nosocomial infection，and implement does not reach the designated position. Under the new trend of developing new diagnosis and treatment technology, continuous increase of susceptible population and continuous transmission of multidrug-resistant bacteria, it is of great practical significance to explore how to construct an intervention plan and to prevent and control nosocomial infection. This paper takes one second-class hospital in a country of Fujian Province as the research object. It uses retrospective study, semi-structured interview method (n=5), brainstorming method (n=5) and prospective intervention method. Through the epidemiological study of nosocomial infection, it analyzes the nosocomial infection and identified the related risk factors. On the basis of in-depth investigation of the status of nosocomial infection management, a set of practical intervention plan is constructed, and the implementation effect of the intervention plan is evaluated and summarized, so as to provide relevant practical experience for the hospital to further strengthen the prevention and control of nosocomial infection, and to provide theoretical reference for the hospital to build a set of effective intervention plan. The results are as follows. 1. The incidence of nosocomial infection was 3.48% and the rate of missing report was 2.98%. The highest infection rate was in the ICU ward. The lower respiratory tract and the urinary tract were the highest infection rate. The risk factors of nosocomial infection include age (old age), hospital stay, operation, and using central venous intubation, ureter intubation, and respirator. The number of days of hospitalization over 13 days is the most important risk factor. 2. On the basis of the analysis of the status of nosocomial infection management, the intervention plan was constructed according to the practical principles, including the screening table of susceptible people, universal intervention measures and targeted intervention measures. It embodies the concept of prevention and emphasizes the importance of hand hygiene, nursing management, and infection monitoring information system for the prevention and control of nosocomial infections. 3. The implementation of the intervention plan improves the status of nosocomial infection on the whole, reduces the incidence of nosocomial infection and the rate of missing report, reduced the rate of infection in key departments and reduced the infection rate of major risk factors. The difference was statistically significant (significant level α=0.1), which achieves the expected goal, but does not realize the secondary target of reducing the infection rate of the common department and reducing the rate of lower respiratory tract infection. It needs to further improve the intervention plan based on the analysis of the causes.
