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消除胸部伤口感染:为什么每个心脏手术项目都需要一个我讨厌感染的团队
Maren Downing1,2, Michael Modrow1,3, Kelly A Thompson-Brazill1,3
1WakeMed Health and Hospitals, Raleigh, NC.
JTCVS techniques
|June 16, 2023
概括
一个多学科团队实施了一种捆绑方法,以预防心脏外科手术中的深胸部伤口感染 (DSWI). 这一策略成功地在12个月内消除了DSWI,将发病率从1.6%降至0%.
科学领域:
- 预防和控制感染的预防和控制.
- 心脏外科手术 心脏外科手术
- 公共卫生 公共卫生
背景情况:
- 深胸部伤口感染 (DSWI) 是心脏手术后的一个严重并发症.
- 现有的研究往往侧重于单个干预措施,对联合策略的协同效应数据有限.
- 需要采用多式联运方式,才能有效降低DSWI费用.
研究的目的:
- 描述一项跨学科的多模式策略,以消除心脏外科手术中的深胸部伤口感染 (DSWI).
- 评估将临床和环境干预措施用于预防DSWI的协同效应.
- 在一个大型社区医院实现零DSWI率.
主要方法:
- 建立一个多学科的感染预防小组 ("我讨厌感染小组").
- 在所有术后阶段 (患者,手术,环境) 识别和实施基于证据的干预措施.
- 关键干预措施包括手术前MRSA查,优化抗生素方案,正常热量,血糖控制,增强OR通风和减少交通.
主要成果:
- 捆绑干预将DSWI发病率从预干预的1.6%降至0%.
- 在干预包完全实施后,连续12个月保持零DSWI率.
- 针对特定的患者,操作和环境因素,以减轻DSWI风险.
结论:
- 一个全面的,捆绑的感染预防方法可以有效地消除心脏外科手术中的深胸部伤口感染.
- 多种干预措施的协同效应,而不是单个组件,可能有助于观察到的成功.
- 这一战略证明了在社区医院环境中实现零DSWI的可行性.
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