我が国の病院における感染管理体制:2008年から2014年にかけての進展と課題

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  • ワガクニ ノ ビョウイン ニ オケル カンセン カンリ タイセイ : 2008ネン カラ 2014ネン ニ カケテ ノ シンテン ト カダイ
  • Infection Control Systems in Japanese Hospitals: Progress from 2008 to 2014

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In this paper, we examined infection control systems in Japanese hospitals from 2008 to 2014. The situation of 2008 was established through surveys of the state of hospital infection control conducted in 2008 , and the infectious disease specialists' (specialists) roster of the Japanese Association for Infectious Diseases, certified nurses in infection control (CNIC) and certified nurse specialists in infection control nursing (CNSICN) roster of the Japanese Nursing Association. The situation in 2014 was established using some specialists, CNIC • CNSICN, and the rosters of medical institutions that had acquired additional charges for the infection control of 1 and 2 from the Regional Bureau of Health and Welfare. Although the number of hospitals with an infection control team (ICT) increased during 2008-2014, there tended to be less ICTs established in small and medium-sized hospitals with <300 hospital beds than in larger-sized hospitals. A total of 81.4% of specialists, 73.6% of CNIC, and 93.1% of CNSICN were affiliated with larger-sized hospitals. Larger-sized hospitals accounted for 77.3% of hospitals that acquired an additional charge for the infection control of 1 with 400 points of additional medical fees, and same-sized hospitals accounted for 53.9% of hospitals throughout Japan. On the other hand, small and medium-sized hospitals accounted for 87.3% of hospitals that acquired an additional charge for the infection control of 2 with an additional 100 points, and same-sized hospitals accounted for 31.7% of hospitals throughout Japan. We believe that the current system, including such components as medical law and medical fees, are not able to fully function in the development of infection control system of small and medium-sized hospitals with >300 hospital beds; as a result, there is a need for an investigation to clarify the reason and for measures that focus specifically on the infection control systems in small and medium-sized hospitals.

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