儿童心脏手术部位感染:一个单一中心的质量改善计划
Nhat Chau1, Crystal Tran2, Megan Clarke3
1Faculty of Art and Science, University of Toronto, Toronto, Ontario, Canada.
JTCVS open
|January 9, 2025
概括
实施新的手术部位带和监测计划显著减少了儿科心脏手术部位感染 (SSI) 的48%. 这项质量改善计划成功降低了SSI比率低于目标水平,提高了患者的安全.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 感染控制 感染控制
- 提高质量 提高质量
背景情况:
- 儿童心脏手术部位感染 (SSI) 是致病率的重要原因之一.
- 该机构的SSI率较高 (100例中3.48例),超过了目标率 (100例中2.5例).
研究的目的:
- 实施旨在将SSI费率降低30%的干预措施,作为质量改善倡议.
- 评估一个新的手术部位包裹和多学科监测计划的有效性.
主要方法:
- 一项对2021年1月至2023年8月儿科心血管手术患者的比较研究.
- 纳入标准:根据国家医疗保健安全网络 (n=1514) 的定义,在索引运行后30天内进行SSI.
- 使用描述性统计数据对干预前 (n=753) 和干预后 (n=761) 队列进行比较.
主要成果:
- 在干预后队列 (100例中的1.97例) 与干预前队列 (100例中的3.85例) 相比,总SSI减少了48% (P=.029).
- 表面性SSI,在1-3周出现的伤口和非新生儿的SSI显著下降.
- 与STS-EACTS先天性心脏外科手术1类死亡率和再入院相关的SSI的减少也很大.
结论:
- 一个新的手术部位包裹和多学科监测计划有效地减少了SSI费用的整体负担.
- 实施的干预措施成功降低了SSI,显示了患者结果的显著改善.
- 未来的研究将专注于确定特定亚群的风险因素,以进一步降低SSI.
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