Development and application of a targeted MISCP-S intervention model for psychiatric hospitals

Objective A multi-modal intervention model (MISCP-S) was constructed based on the characteristics of psychiatric medical institutions, to evaluate its impact on the pathogen detection specimen submission rate related to healthcare-associated infection diagnosis and the effect of rational antibacterial use. Methods In a large tertiary psychiatric hospital, we established the MISCP-S Intervention Model (Multidisciplinary Collaboration, Informatization and Intelligence, Stratified Training, Constraints and Incentives, and Process Optimization) tailored to specialty-specific infection control challenges. 1343 HAI cases were collected as the pre-intervention group from January 2022 to November 2023, and 677 cases were collected as the post-intervention group from March 2024 to July 2025. Results The pathogen detection specimen submission rate increased significantly from 69.47% to 98.38% (P < 0.05), with the appropriateness rate of tests ordered reaching 100%. This improvement was most pronounced in departments with previously low submission rates, such as the acute psychiatric department (P < 0.05). Multivariate logistic regression identified the intervention, patient location in ICU/internal medicine/chronic care units, and urinary tract infection as significant facilitating factors for specimen submission (all P < 0.05). The therapeutic antimicrobial use rate decreased from 16.03% to 14.61% (P < 0.05). The overall detection rate of multidrug-resistant organisms (MDROs) decreased from 37.44% to 33.74% (P < 0.05). Notably, detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) decreased significantly (both P < 0.05). In contrast, the rate of carbapenem-resistant Enterobacterales (CRE) increased from 14.35% to 23.56% (P < 0.05). The proportions of blood cultures and bronchoscopy samples rose from 14.94% to 22.34% and from 3.88% to 8.63%, respectively (both P < 0.05). Conclusion The MISCP-S intervention model appears to be associated with improvements in specimen submission quality, reductions in overall MDRO detection rates, and enhanced antimicrobial stewardship in psychiatric settings. These findings suggest that the model may offer a replicable framework for similar healthcare institutions.