患者遵守对关节和膝关节置换中黄金葡萄球菌脱殖战略的实施
Lindsay Whelan1, Jenine Leal2, Myles Leslie3
1Strategic Clinical Network, Alberta Health Services, AMR-One Health Consortium, Departments of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
American journal of infection control
|June 24, 2023
概括
评估了患者对手术前抗微生物脱殖的遵守,用于关节和膝关节置换手术. 农村诊所的合规性更高",病人忘记"是不合规的常见原因.
科学领域:
- 感染控制 感染控制
- 手术患者护理手术患者护理
- 抗微生物药物管理委员会
背景情况:
- 在加拿大阿尔伯塔省,使用使用赫西丁葡萄酸盐 (CHG) 海绵和mupirocin膏的手术前抗菌解殖方案,以减少关节和膝关节置换患者的手术部位感染 (SSIs).
- 患者遵守该协议对于其在预防SSI方面的有效性至关重要.
- 了解合规模式和障碍对于优化协议实施至关重要.
研究的目的:
- 为了确定患者遵守手术前抗微生物脱殖协议的比例.
- 为了确定患者报告的不遵守CHG海绵和mupirocin药膏协议的原因.
- 根据诊所位置和协议改进,探索合规性的变化.
主要方法:
- 在阿尔伯塔省的七家诊所,在接受选择性全关节或膝关节置换的患者中进行了一项描述性调查.
- 收集了关于患者遵守和不遵守原因的数据.
- 描述性统计和多变量逻辑回归被用于分析.
主要成果:
- 在3,427名患者中评估了合规性.
- 在基线和增强协议之间没有观察到遵守的显著差异.
- 与城市诊所相比,农村诊所的合规性明显高 (赔率比=4.47,P<.001).
- 不遵守最常见的原因是"病人忘记了".
结论:
- 增强的协议没有改变合规率.
- 诊所的位置显著影响了合规性,农村环境显示了更高的合规性.
- 违规的主要原因包括"没有提供海绵"",病人忘记了"和"手术日期被移动".
- 这些发现可以指导诊所改善患者遵守脱殖协议,以加强SSI预防.
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