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首页> 外文期刊>Journal of Hospital Administration >A predicted outbreak in an overcrowded, administratively neglected and run-down haemodialysis unit as an offer of “New Public Management” in Norwegian hospitals
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A predicted outbreak in an overcrowded, administratively neglected and run-down haemodialysis unit as an offer of “New Public Management” in Norwegian hospitals

机译：挪威医院中拥挤不堪，行政上被忽视且破败不堪的血液透析病房的预计爆发，是“新公共管理”活动的开端

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Background: Scandinavian countries had a low rate of vancomycin- resistant enterococci (VRE) until 2007. Since 2007, there has been an alarming spread of VRE in Sweden and later on in Norway. From 2002 on, public hospitals in Norway were transferred from the County administration to a few regional state enterprises, drifted and organized according to the “New Public Management” (NPM), to save money. Four hospitals in Oslo, including Ullev?l University Hospital, were, of the same reason, further merged into a 1500 beds Oslo University Hospital in 2009. Methods: This study included the hospital management of infection control and attitudes to reports from routine inspections in a haemodialysis unit at Oslo University Hospital (OUS) - before and after an outbreak of VRE in 2011. Results: Before the outbreak of VRE, repeated site inspections by infection control personnel revealed overcrowding, a poor hospital design, a low hygienic standard, and an imminent risk for hospital infection in a haemodialysis unit at OUS. Reports concerning deviation from proper infection control were sent to the hospital administration. Two project groups were set down consecutively within a year to solve the problems. They were both nearly immediately put on hold because of lack of economic resources. The Board of Health in the Counties of Oslo and Akershus (having the overall supervision of the health care in the Counties) was then notified by the infection control doctor. The outbreak of VRE was detected in May 2011 in this haemodialysis unit. It was promptly stopped after one month, by using a combination of several restrictive infection control methods. All VRE cases were negative after repeated negative samplings for a year. The outbreak resulted in a response from the hospital administration to the serious conditions in this unit. One and a half year later, an extended, refurbished new unit was ready for the patients. Conclusion: A low hygienic standard in an overcrowded and run-down haemodialysis unit was neglected by an administrative organization lacking economic resources after following the ideas of NPM through many years. This situation finally led to an outbreak of VRE. An early and restrictive intensive intervention leads to a rapid termination of the outbreak.
机译：背景：斯堪的纳维亚国家直到2007年的耐万古霉素肠球菌（VRE）发病率都很低。自2007年以来，VRE在瑞典以及随后在挪威的传播范围令人震惊。从2002年起，挪威的公立医院从县政府转移到一些地区性国营企业，根据“新公共管理”（NPM）的要求进行了组织和组织，以节省资金。出于同样的原因，奥斯陆的四家医院（包括Ullev？l大学医院）于2009年进一步合并为一张拥有1500张病床的奥斯陆大学医院。方法：本研究包括医院对感染控制的管理以及对常规检查报告的态度。奥斯陆大学医院（OUS）的血液透析部门-在2011年VRE爆发前后。结果：在VRE爆发之前，感染控制人员进行了多次现场检查，发现人满为患，医院设计差，卫生标准低以及在OUS的血液透析室有即将发生医院感染的风险。有关偏离适当感染控制措施的报告已发送给医院管理部门。一年内连续成立了两个项目组来解决这些问题。由于缺乏经济资源，它们几乎都被立即搁置。然后，感染控制医生通知了奥斯陆和阿克斯胡斯县卫生委员会（对县的医疗保健进行了全面监督）。 2011年5月在该血液透析部门检测到VRE爆发。一个月后，通过结合使用几种限制性感染控制方法，迅速将其停止。经过一年的反复阴性抽样后，所有VRE病例均为阴性。爆发导致医院管理部门对该部门的严峻状况作出了反应。一年半后，一个扩展的，翻新的新病房已为患者准备就绪。结论：在遵循NPM理念多年之后，缺乏经济资源的行政组织忽视了拥挤而破败的血液透析室的低卫生标准。这种情况最终导致了VRE的爆发。尽早进行限制性的密集干预可导致爆发快速终止。

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