醫(yī)院感染目標性監(jiān)測譯(編輯修改稿)
2025-02-27 17:23 本頁面
【文章內容簡介】 So You Can: ? 制定有意義的干預措施Develop meaningful interventions ? 做減少感染的工作 DO something to reduce infections ? 改善患者的醫(yī)療護理 Improve patient care! 18 目標性監(jiān)測的成功周期 The Cycle for Success Through Targeted Surveillance 1. 是否有重要的問題 2. Is there an important problem? 3. 4. 是什么，為什么？多專業(yè)的控制人員 5. What, why? 6. Multidisciplinary Teams Describe and understand the problem? 目標性監(jiān)測 Targeted Surveillance 3. 怎樣去改進 How to affect change? 多專業(yè)的控制人員 Multidisciplinary Teams 教育 Education 反饋 Feedback 新方案 New protocols 新產品 New products 4. 改進措施是否有效？ Do the changes work? 再評價 Remeasure Adapted from: Richards C, et al. Emerg Infect Dis 2023 19 NLM Ignaz Semmelweis Targeted Surveillance And Intervention For Puerperal Sepsis 20 針對過程 的目標監(jiān)測 Targeted Surveillance for a Process 抗生素預防手術部位感染的時機選擇 Timing of Antibiotic Prophylaxis for Surgical Site Infection NLM Archives 21 ？ Is There an Important Problem? ? 外科不合理的預防使用抗微生物藥物是一種主要的感染危險 Inappropriate surgical prophylaxis is a major infection risk – 患者暴露于不必要的毒性 exposes patient to unnecessary toxicity – 增加耐藥性 increases antimicrobial resistance – 過量或不適當的抗菌譜使用并不能降低手術傷口感染的發(fā)生率 excess doses or inappropriate spectrum antibiotics do not reduce the incidence of surgical wound infection 22 理想的預防使用方法 “ Ideal” Prophylaxis ? 理想的預防性應用 Ideal antibiotic for prophylaxis –有效地殺滅可能污染傷口的病原菌 active against pathogens most likely to contaminate wound –在潛在的污染期間保持足夠的濃度 adequate concentrations during potential contamination –短期應用以減少并發(fā)癥，耐藥及費用 administered for a short time to reduce plications, resistance, and cost 23 Targeted Process Surveillance Timing of Perioperative Antimicrobial Prophylaxis 01234562 2 1 1 2 3 4 5 6 7 8 9 10 10 SSIs / 100 proceduresClassen DC, et al. The timing of prophylactic administration of antibiotics and the risk of surgicalwound infection. N Engl J Med 1992。326:281 Incision Hours before incision Hours after incision Antibiotic Administered 24 圍手術期抗微生物藥物預防應用的時機 Timing of Perioperative Antimicrobial Prophylaxis T i m e o f a d m i n i s t r a t i o n i n r e l a t i o n t o t h e i n c i s i o n o f P a t i e n t s ( % ) R e l a t i v e R i s k o f I n f e c t i o n 2 2 4 h o u r s b e f o r e 3 6 9 ( 1
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