医院感染目标性监测译 0drqpu6t.ppt

* Targeted Surveillance for Outcomes 医院感染率NI Rate: VAP CR-BSI UTI Foley related Non-Foley related 采取干预措施的目的Drives Intervention For: Pneumonia prevention CR-BSI prevention Foley-care, d/c program Peri-care / hydration * 1.是重要问题吗？Is There an Important Problem? 呼吸机相关性肺炎对患者是一个主要感染危险Ventilator - associated pneumonia is a major infection risk for patients 增加病死率 increased mortality 延长住院时间 excess length of stay 增加医疗费用 excess cost * Example: Challenge for Targeted Surveillance 将呼吸机相关性肺炎降低50％ Reduce ventilator associated pneumonias (targeted adverse event) by 50% # VAP infections # 1000 ventilator days * 通过目标监测和干预减少呼吸机相关性肺炎Reduction of VAP with Targeted Surveillance and Interventions Kwan KL, Baker SP, Fontecabio SA. Impact of a program of intensive surveillance and interventions targeting ventilated patients in the reduction of ventilator-associated pneumonia, and its cost effectiveness ICHE 2003;24;11:859-63. * Reduction of VAP with Targeted Surveillance and Interventions 干预措施Interventions: 抬高床头Raise head of bed 管道给予灭菌水Sterile water for tube feedings 24 - 48 -72- 根据需要应用气管导管In-line suction catheters from 24 - 48 -72- as needed 每年节约花费$350，000 Cost savings $350,000 in one year. * 1. Is There an Important Problem? 导管相关血流感染是一种严重的感染危险因素Catheter-related bloodstream infections are a serious infection risk 导管相关的device-related 发病率和病死率morbidity and mortality 延长住院时间extra length of stay 额外医药花费additional medical costs * 0 5 10 15 20 25 Jan April July Oct Jan April July Oct Jan 98 99 00 SICU BSI Jan 98 - March SICU BSI Jan 98 - March ‘00 Rate per 1,000 line days Rate per 1,000 line days Example: Challenge for Targeted Surveillance * 2.针对问题进行目标监测Perform Targeted Surveillance for This Problem 对外科ICU患者进行血液感染的监测 Monitor blood stream infections in Surgical ICU patients. * 3. 改进Affect Change血液系统感染目标性监测的成功干预措施 Successful interventions from targeted surveillance for BSI  成功的教育计划以减少导管相关血液系统感染 Successful education program to re