醫(yī)院感染目標(biāo)性監(jiān)測譯-資料下載頁
2025-02-09 17:23本頁面
【正文】 ntilator associated pneumonias (targeted adverse event) by 50% VAP infections 1000 ventilator days 34 通過目標(biāo)監(jiān)測和干預(yù)減少呼吸機(jī)相關(guān)性肺炎Reduction of VAP with Targeted Surveillance and Interventions Unit 1997 1998 Red uc tionSICU 45 .1 /10 00 VD27 .9 /10 00 VD17 .2 /10 00 VDMI CU 22 .4 /10 00 VD11 .6 /10 00 VD10 .8 /10 00 VDKwan KL, Baker SP, Fontecabio SA. Impact of a program of intensive surveillance and interventions targeting ventilated patients in the reduction of ventilatorassociated pneumonia, and its cost effectiveness ICHE 2023。24。11:85963. 35 Reduction of VAP with Targeted Surveillance and Interventions ? 干預(yù)措施 Interventions: –抬高床頭 Raise head of bed –管道給予滅菌水 Sterile water for tube feedings – 24 48 72 根據(jù)需要應(yīng)用氣管導(dǎo)管 Inline suction catheters from 24 48 72 as needed ? 每年節(jié)約花費(fèi) $350， 000 Cost savings $350,000 in one year. 36 1. Is There an Important Problem? ? 導(dǎo)管相關(guān)血流感染是一種嚴(yán)重的感染危險因素 Catheterrelated bloodstream infections are a serious infection risk – 導(dǎo)管相關(guān)的 devicerelated – 發(fā)病率和病死率 morbidity and mortality – 延長住院時間 extra length of stay – 額外醫(yī)藥花費(fèi) additional medical costs 37 0 5 10 15 20 25 Jan April July Oct Jan April July Oct Jan 39。98 39。99 39。00 SICU BSI Jan 39。98 March SICU BS ‘ 00 Rate per 1,000 line days Rate per 1,000 line days Example: Challenge for Targeted Surveillance 38 Perform Targeted Surveillance for This Problem 對外科 ICU患者進(jìn)行血液感染的監(jiān)測 Monitor blood stream infections in Surgical ICU patients. 39 3. 改進(jìn) Affect Change 血液系統(tǒng)感染目標(biāo)性監(jiān)測的成功干預(yù)措施 Successful interventions from targeted surveillance for BSI 1. 成功的教育計劃以減少導(dǎo)管相關(guān)血液系統(tǒng)感染 Successful education program to reduce catheter associated blood stream infections 2. 置管時應(yīng)用無菌手術(shù)巾和全套個人防護(hù)設(shè)備 Drapes and full PPE during insertion 3. 對插管部位進(jìn)行監(jiān)測和護(hù)理 Monitoring and care for site 40 4. 改進(jìn)是否有效 Do the changes work? ? 新的改良操作實(shí)施后 3個月內(nèi)再檢查 Remeasure in 3 months after initiation of new improved procedure ? 監(jiān)測血流感染率 Measure bloodstream infection rates. 41 0 5 10 15 20 25 Jan April July Oct Jan April July Oct Jan 39。98 39。99 39。00 SICU BSI Jan 39。98 March SICU BS ‘ 00 BSI Intervention ntions Rate per 1,000 line days Rate per 1,000 line days Example: Challenge for Targeted Surveillance 42 With targeted surveillance 目標(biāo)性監(jiān)測改善結(jié)局 43
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