Study On The Construction Of Nosocomial Infection Risk Scale Of General ICU Patients With Multidrug-resistant Organisms

Objective: Multi-drug resistant bacteria are the main cause of nosocomial infection in severe patients,and can directly affect the patient’s organism status and clinical outcome.Therefore,early prevention of the occurrence of multi-drug resistant bacteria nosocomial infection is of great significance for clinical diagnosis,treatment and care.Of this study was to explore factors influencing hospital multi-resistant bacteria infection,on the basis of the science of scaling principle and method of building hospital multi-resistant bacteria infection risk assessment tools,in order to help nurses in patients with early assessment of the risk of hospital infection,multi-resistant bacteria to take targeted measures to provide basis for clinical medical care,and reduce the incidence of hospital infection multi-resistant bacteria,promote the quality and level of hospital infection management.Methods:(1)Construct the item pool of the scale.Through literature review,semi-structured interview and group discussion,the influencing factors of nosocomial infection of multidrug-resistant bacteria were extracted to form the item pool of the scale.(2)select items of the scale..The clinical data of 950 ICU patients were analyzed,and entries were screened by logistic regression method.(3)Scale formation.Based on the screening results of the above items,the weight of each item was calculated based on the regression coefficient,the ROC curve was used to determine the diagnostic threshold of the scale,and the degree grading of the scale was determined by the quartile method,thus forming a complete Scale of hospital infection risk of Multiple drug-resistant bacteria in general ICU patients.(4)Evaluation of reliability and validity of scale.Structural validity,content validity and internal consistency reliability test were used to verify the validity of the scale.Results: 1.Through literature research,39 influencing factors of nosocomial infection of multi-drug resistant bacteria were extracted.During the semi-structured interview,the possible risk factors were further analyzed.The basic framework of the scale was formed by combining the results of the two methods and some clinical data after group discussion..2.Screening of nosocomial infection scale entries for multidrugresistant bacteria.Based on the screening items of clinical data,univariate and multivariate analyses were performed by Logistic regression to determine 7 items,including gender,general ICU stay days before infection,cardiovascular and cerebrovascular diseases,number of surgeries before infection,indwelling catheter,ventilator and nutritional support.3.Determination of the weight,scale diagnostic threshold and grade of the risk of nosocomial infection of multidrug-resistant bacteria.3.1 Weight of itemsThe weight of each item was determined based on the multi-factor regression coefficient.The weights of each item were assigned to 2,3,1,2,3,4 and-4 respectively for gender,general ICU stay days before infection,cardiovascular and cerebrovascular diseases,number of surgeries before infection,indwser,ventilator use and nutrition support.3.2 Diagnostic threshold of scaleIn this study,the ROC curve area was 0.775,P=0.000< 0.01,the sensitivity was 69.7%,and the specificity was 76.9%.The diagnostic threshold of the final scale was 3 points,that is,when the evaluation result was higher than 3 points,it could be concluded that patients were at risk of hospital infection with multi-drug-resistant bacteria.3.3 Scale degree gradingThe rating scale was as follows: 3 < score ≤5: Indicating a low risk of developing MDRO hospital infection;6≤ score ≤7: Indicates that the risk level of the patient is intermediate;Score ≥8: indicates that the risk level of the patient is high.4.Evaluation of the reliability and validity of the Nosocomial infection Risk Scale for multidrug-resistant bacteria in general intensive care unit.In the structural validity evaluation,KMO=0.52,the common factor can explain the contribution rate of the population variance more than 50%,indicating that the scale is of good accuracy and the internal consistency reliability is 0.33.5.The validity of the scale was preliminarily verified with the validation data.The sensitivity and specificity were 79.31% and 78.06% respectively,indicating that the scale had a good evaluation effect.Conclusion: The developed general ICU patient MDRO hospital infection risk scale has good diagnostic sensitivity,specificity and validity,with general reliability.