危急病患者的抗生素管理和医院感染预防:质量改善计划
Nayá Saad Custódio1, Luana Fernandes Machado2, Graziela Denardin Luckemeyer2
1Faculty of Medicine of São José do Rio Preto - São José do Rio Preto (SP), Brazil.
Revista da Associacao Medica Brasileira (1992)
|May 22, 2024
概括
实施"抗生素管理和鼻腔感染预防计划",在重症监护室减少了抗生素使用和与医疗相关的感染. 这项质量改进计划证明了可行性和积极的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 医疗相关感染 (HAI) 和抗菌素耐药性在重症监护病房 (ICU) 中构成重大挑战.
- 有效的抗生素管理计划对于优化抗菌剂使用和预防耐药性至关重要.
- 实施全面的感染预防策略对于ICU患者的安全至关重要.
研究的目的:
- 评估捆绑干预计划对抗生素和设备利用的影响.
- 评估该计划对医疗保健相关感染在ICU的发生率的影响.
- 确定ICU环境中质量改善举措的可行性和有效性.
主要方法:
- 一个准实验性的研究设计,比较干预前和干预后的时期.
- 利用连续的病例系列来评估抗生素和设备使用的变化.
- 抗微生物消耗量是用定义的每日剂量 (DDD) 来衡量的.
主要成果:
- 在干预后 (89±8至77±11) 观察到总体抗菌素消耗 (DDD每100个患者日) 的下降.
- 在使用特定类型的抗生素,包括卡巴,糖,多,青素和类药物的使用中,注意到了显著的减少.
- 中枢静脉导管使用率从76%降至70%,呼吸机使用率从52.8%降至44.1%.
- 在干预后,医疗保健相关感染率从19.2%下降到15.5%.
结论:
- 质量改善举措,特别是那些专注于抗菌药物管理和HAI预防的举措,在ICU中是可行的.
- 实施的计划显示了降低抗生素消费和医疗保健相关感染率的潜力.
- 捆绑干预可以有效地提高患者安全,并优化重症监护机构的资源利用率.
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