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在剖腹产期间更换手套:对产妇服务预算和能力的影响
B Stanberry1, L Jordan2, A Pullyblank3
1Institute of Healthcare Leadership and Management, Oxford, UK.
The Journal of hospital infection
|November 15, 2025
概括
在剖腹产 (CB) 后更换手套显著减少手术部位感染 (SSI). 这种做法预计将通过降低治疗成本和提高医疗保健能力,在五年内为英格兰NHS节省4510万英.
科学领域:
- 产科和妇科 产科和妇科
- 预防传染病 预防传染病
- 卫生经济学 卫生经济学
背景情况:
- 剖腹产 (CB) 后的手术部位感染 (SSI) 造成了重大的临床和经济负担.
- 目前的做法可能低估了后CBSSI的发病率,因为后续不充分.
- 在CB期间胎盘分娩后更换手套是一种已知的干预措施,以减少SSI率.
研究的目的:
- 分析在英国国家卫生服务 (NHS) 中在胎盘分娩后在CB期间采用常规手套更换的预算和能力影响.
- 估计一个典型的NHS产妇服务和整个英格兰NHS的成本节约和资源影响.
- 评估将这种感染控制措施作为标准实践实施的经济效益.
主要方法:
- 使用皇家联合医院巴斯NHS基金会信托基金会的数据开发了一种5年预算影响模型.
- SSI发病率是通过30天的免费调查问卷来确定,并与国家成本数据相结合.
- 该模型通过比较当前成本与未来成本,考虑手套更换时间和成本来计算净预算影响,并通过敏感性分析探索不确定性.
主要成果:
- 据估计,在当地信托机构实施手套更换可以在第一年节省59,478英,并在五年内节省339,654英.
- 大幅节省 (254,507英) 来自减少社区助产士的访问和医院再入院,并为一般诊所节省额外的费用.
- 在全国范围内推断,手套更换可以在五年内为英格兰NHS节省4510万英,在敏感性分析中得到了强有力的发现.
结论:
- 在CB期间的胎盘分娩后,常规的手套更换可以显著减少术后感染,从而大大节省成本,并释放产妇服务的能力.
- 调查结果表明,这种干预对个人信托和更广泛的英格兰NHS都具有经济利益.
- 改善放出后的监测对于在未来的研究中准确报告SSI发病率至关重要.
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