在11家退伍军人事务医院实施预防套餐,降低黄金葡萄球菌手术部位感染率
Hiroyuki Suzuki1,2, Eli N Perencevich1,2, Stacey Hockett Sherlock1,2
1Center for Access and Delivery Research & Evaluation (CADRE), Iowa City Veterans' Affairs Health Care System, Iowa City, Iowa.
JAMA network open
|July 20, 2023
概括
一个手术部位感染 (SSI) 预防包显示,在全关节整形术 (TJA) 后,有可能减少金黄色葡萄球菌感染. 然而,该研究缺乏证实长期有效性的能力,特别是在心脏手术中.
科学领域:
- 传染性疾病 传染性疾病
- 外科手术的结果
- 提高质量 提高质量
背景情况:
- 由黄金葡萄球菌引起的手术部位感染 (SSI) 仍然是一个令人担忧的问题.
- 现有的预防包,包括查和脱殖,可以减少SSI.
- 调整干预措施以适应设施层面的因素对于有效性至关重要.
研究的目的:
- 评估灵活的SSI预防包与S. aureus深切口或器官空间SSI率之间的关联.
- 评估设施自由裁量权在实施捆绑组件方面的影响.
主要方法:
- 在11家退伍军人管理局医院进行质量改进研究.
- 包括接受冠状动脉旁路移植,心脏门置换或全关节整形术 (TJA) 的患者.
- 使用通用估计方程 (GEE) 和中断时间序列 (ITS) 模型进行分析.
主要成果:
- 共有95种S. aureus深切口或器官空间SSI被确定.
- 该GEE模型表明,干预和TJA后SSI率下降之间存在显著的关联 (aOR,0.55).
- 对于心脏手术没有发现任何显著的关联,ITS模型也没有证实TJA的发现.
结论:
- 在TJAs之后,SSI预防包可能与减少的S. aureusSSI有关.
- 该研究不足以检测出具有统计学意义的长期影响.
- 需要进一步的研究来证实可适应的SSI预防策略的有效性.
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