長期照護機構感染管制查核結果及缺失改善情形──以一般護理之家為例

為提升長期照護機構照護品質，降低醫療照護相關感染的發生，疾病管制署自2014年起推動感染管制查核作業，並持續透過修法、感染管制查核、增修訂定感染管制措施指引、委託專業團體辦理手部衛生推廣計畫及實體或數位學習課程等方式，推動長照機構提升感染管制品質。為瞭解外部稽核機制及提供相關輔導資源對於長期照護相關機構感染預防與控制之影響，本研究以一般護理之家為例，分析2014年、2015年及2019年感染管制查核結果，評估受查核機構之感染管制措施執行及改善情形等。全國一般護理之家於2014年、2015年及2019年接受感染管制查核家數，分別為328家、188家及358家。受查機構感染管制查核結果之合格率（符合60%以上查核基準）於2014年、2015年及2019年，分別為99.7%、97.3%及99.7%，顯示多數機構能達成感染管制基準之基本要求。受查機構感染管制查核結果之優良率（符合全數查核基準所有要求）於2014年、2015年及2019年，分別為24.4%、16.0%及46.9%，顯示於2014年及2015年辦理查核作業初期僅有少數機構感染管制措施執行成果達成優良，但於導入查核及輔導資源數年後，2019年受查機構優良率較前期顯著提升，顯示相關政策推動有助於提升長期照護機構感染預防及控制的落實度。

To improve the quality of care in long-term care facilities (LTCFs) and reduce the occurrence of healthcare-associated infections, Taiwan Centers for Disease Control (TCDC) has coordinated infection control inspection programs since 2014, as well as through amended the laws, revised infection control measures guidelines, commissioned professional groups implement hand hygiene promotion programs, and organized in-person or e-learning training courses to promote LTCFs to improve the quality of infection control. To understand the impact of external audit mechanisms and the provision of relevant coaching resources on infection prevention and control in LTCFs, we evaluated the implementation and improvement of infection control measures in nursing homes by analyzing the infection control inspection results in 2014, 2015, and 2019.
The number of nursing homes that underwent infection control inspections in 2014, 2015, and 2019 was 328, 188, and 358, respectively. There were 99.7%, 97.3%, and 99.7% of facilities being assessed qualified in 2014, 2015, and 2019, respectively, indicating that most facilities could meet the basic requirements for infection control. The excellent rates (meeting all requirements of the inspection standards) were 24.4%, 16.0%, and 46.9%, respectively, in 2014, 2015, and 2019. This shows that in the early stages of the inspection program in 2014 and 2015, only a few facilities achieved excellent results in implementing infection control measures. However, several years after the introduction of auditing and coaching resources, the excellent rate of facilities inspected in 2019 increased significantly compared with the previous period, indicating that the promotion of relevant policies can help improve the effectiveness of infection prevention and control in LTCFs.