在药物管理期间,护理人员与NICU环境的互动增加可能导致更高的感染率:试点观察性研究
Mark Nolan1, Belinda Chan2,3, Catherine Loc-Carrillo4,5
1Neonatal-Perinatal Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
American journal of perinatology
|July 14, 2025
概括
新生病重症监护室中中枢线相关血流感染 (CLABSI) 的增加与静脉注射药物整合的变化有关. 这些过程变化可能会无意中增加患者感染风险,通过提高护理人员与环境的相互作用.
科学领域:
- 新生儿重症监护病房 (NICU) 感染控制病房
- 与医疗保健相关的感染 (HAI)
- 患者安全和质量改善.
背景情况:
- 新生儿重症监护室 (NICU) 努力实现零的中央线路相关血流感染 (CLABSI).
- 从2019年开始,在一个NICU中观察到CLABSI和其他血液感染 (BSI) 的显著增加.
- 这一增加与静脉注射 (IV) 药物整合过程的修改相吻合.
研究的目的:
- 调查静脉注射药物整合过程的变化与增加的CLABSI和BSI率之间的潜在关联.
- 在实施质量改善项目之前,确定导致感染率上升的因素.
主要方法:
- 使用混合方法方法的观察试点研究.
- 统计过程控制分析以确认增加的CLABSI率.
- 人类因素观察和环境微生物组采样IV集成设备.
- 结果与时间和地理关联的CLABSI和BSI率进行比较.
主要成果:
- 在2019年IV整合变化后,观察到CLABSI和BSI利率的统计显著增加.
- 修改后的过程涉及更多的步骤,增加了护理人员与环境的相互作用和药物给药时间.
- 环境采样显示了27%的阳性率,在静脉注射期间使用的患者特定移动设备的微生物负担更高.
- 凝聚酶阴性葡萄球菌 (CONS) 在新生儿重症监护室环境和患者血培养中普遍存在.
结论:
- 修改的输液整合,虽然旨在提高安全性,但可能会产生意想不到的后果,包括增加感染风险.
- 该过程的增加复杂性和持续时间可能会导致更多的护理人员与环境的互动,暴露脆弱的新生儿.
- 需要进一步的研究和质量改进工作,以简化静脉注射过程,减少微生物负载以降低感染率.
相关概念视频
Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
Standard Precaution
2.2K
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
2.2K
Endocarditis IV: Nursing Management
37
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
37
Nursing Implementation
5.3K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
5.3K
Hand hygiene
4.2K
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
4.2K
Urinary Tract Infection IV: Nursing Management
89
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
89


