概括
一项关于退伍军人管理局医院预防性抗生素处方的调查发现,与专家指南有显著的偏差,过度使用是主要问题. 大多数外科医生都愿意接受正式的审计反,以改善处方实践.
科学领域:
- 传染性疾病 传染性疾病
- 在外科手术实践中.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预防性抗生素的使用在手术中是标准的,但需要遵守指南.
- 处方习惯的变化可能导致不理想的结果和抗菌素耐药性.
- 退伍军人管理局 (VA) 制定了针对抗菌素使用的专家指南.
研究的目的:
- 评估当前的预防性抗生素处方实践在VA的外科主任.
- 将这些做法与已建立的VA专家委员会指南进行比较.
- 确定不一致的领域和潜在的干预措施.
主要方法:
- 一项调查分发给整个VA系统的外科服务主管.
- 实现的响应率为99%.
- 处方习惯与VA中央办公室专家委员会指南进行了比较.
主要成果:
- 平均而言,医院与专家指南的一致性得分为62.4%,这表明存在很大的差距.
- 大多数处方错误都涉及过度使用抗生素,而不是过少使用.
- 医院规模和大学附属关系与处方遵守没有相关性.
结论:
- 在VA手术服务中,有很大的机会改善预防性抗生素处方.
- 正式审计和反机制,而不是非正式的回合,可能更有效.
- 高级外科医生表示愿意采用审计驱动的指导方针,建议改善的途径.
相关概念视频
Healthcare Associated Infections II: Preventive Measures
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Hand hygiene
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
Transmission-based Precautions II: Airborne and Protective Environment
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Standard Precaution
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Transmission-based Precautions I: Contact, Enteric, and Droplets
Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Smallpox
Smallpox is a severe contagious disease caused by the Variola major virus, a double-stranded DNA member of the Poxviridae family.Variola major transmission occurs primarily via inhalation of virus-laden droplets or direct contact with infectious scabs. The incubation period averages approximately seven days, although it may range from 7 to 17 days depending on the inoculum and host factors.Clinically, the prodromal phase is marked by an abrupt onset of high fever, malaise, headache, and myalgia.
