Evaluation of the effectiveness of hospital infection prevention and control based on the SMART principle.

Abstract

Hospital infection not only increases patient suffering and mortality, but also causes huge economic losses. It is urgent to take effective measures to improve the situation of hospital infection and focus on hand hygiene and disinfection. The SMART principle is to follow the principles of specificity, measurability, attainability, relevance, and timeliness when setting goals. This study aims to use the SMART principle in the prevention and control of hospital infection, to take a series of measures on the hospital infection such as hand hygiene, and to evaluate the implementation effect. This study is a retrospective study. From January to June 2020, the SMART principle was used to carry out intervention for infection prevention and control in the Xiangya International Medical Department, Central South University, and implement the infection prevention and control quality improvement plan. Using indicator data as targeting measurement standard, we established evaluation indicators for hospital infection prevention and control knowledge awareness and hand hygiene compliance rate as the process monitoring, surgical site infection rate and catheter-related urinary tract infection rate as the result monitoring. The evaluation indicators after intervention (July 2020 to June 2021) were compared with those before intervention (January 2019 to December 2019). Fifty-one medical staff working in the Xiangya International Medical Department were included. There were 12 doctors and 39 nurses, and 6 males and 45 females. The age ranged from 21 to 57 (30.2±7.1) years. After the intervention, the awareness of hospital infection prevention and control knowledge and hand hygiene compliance rate of medical staff were significantly higher than those before the intervention (both P<0.05), but there were no significant differences in surgical site infection rate and catheter-related urinary tract infection rate before and after intervention (both P>0.05). After the intervention, the awareness of hospital infection prevention and control knowledge and hand hygiene compliance rate of medical staff in the internal and surgical wards were higher than those before the intervention (all P<0.05). The awareness of hospital infection prevention and control knowledge of medical staff in surgical wards was low but improved significantly. The compliance rate of hand hygiene of medical staff in internal wards was high and improved significantly. After the intervention, the awareness of hospital infection prevention and control knowledge and hand hygiene compliance rate of male and female medical staff were higher than those before the intervention (all P<0.05), both of which were significantly higher in males than in females. After the intervention, the awareness of hospital infection prevention and control knowledge and hand hygiene compliance rate for medical staff aged less than 30 years old and 30 to 40 years old were higher than those before the intervention (all P<0.05). Medical staff aged 30 to 40 years had a low awareness of hospital infection prevention and control knowledge, but both indicators improved most significantly. After the intervention, the awareness of hospital infection prevention and control knowledge of doctors and nurses was increased (both P<0.05). The awareness of doctors improved more significantly, and the hand hygiene compliance rate of nurses improved (P<0.05). After the intervention, the awareness of hospital infection prevention and control knowledge and hand hygiene compliance rate of medical staff with primary and intermediate professional titles were higher than those before the intervention (all P<0.05), and the improvement was more significant for medical staff with intermediate professional titles. Based on the SMART principle management method, the implementation of quality improvement plans combined with various domestic and international evaluation standards for infection prevention and control can effectively improve the awareness of infection control knowledge and hand hygiene compliance rate of medical staff, strengthen the prevention and control of hospital infection, and further ensure the safety of patients.