进行手术前皮肤准备的实践训练可以提高对制造商使用说明的遵守
Diego Schaps1, Michael Schultz2, Regina Woody2
1Department of Surgery, Duke University Health System, Durham, NC, USA.
一次单一的培训会改善了手术部位感染 (SSI) 预防的遵守. 然而,对SSI费率的积极影响是暂时的,强调了需要持续教育和监测的需要.
科学领域:
- 改善外科手术的质量
- 感染控制 感染控制
- 医学教育 医学教育
背景情况:
- 手术部位感染 (SSI) 显著增加患者的发病率和医疗保健成本.
- 该机构的SSI在2022年获得了国家外科质量改善计划 (NSQIP) 的"改善需求"评级.
- 启动了一项有针对性的计划,以提高手术前皮肤准备的坚持性.
研究的目的:
- 评估一次性实践培训计划对手术前皮肤准备合规性的影响.
- 评估改善合规性对机构SSI利率的后续影响.
- 为了确定手术质量指标的培训干预措施的持久性.
主要方法:
- 为外科住院生和手术室护士进行了一次单一的实践培训.
- 专注于遵守赫西丁葡萄糖酸盐和异醇 (CHG/IPA) 协议.
- 从2022年8月到2023年11月,通过直接观察 (N=1032) 监测了合规性,通过NSQIP报告分析了SSI发生率.
主要成果:
- 对手术前皮肤准备的完全遵守率从13.3%上升到39.4% (p < 0.0001).
- 调整后的合规率显著增加:整体3.4倍,整体手术3.7倍,结直肠手术9.8倍 (所有p < 0.0003).
- 机构NSQIP的SSI评级暂时从"改善需求"提高到"预期"但随后逆转.
结论:
- 一次单一的培训干预有效地提高了手术前皮肤准备的遵守性,并与SSI评级的初始改善有关.
- 观察到的SSI利率上的好处没有持续,这表明缺乏持久性.
- 持续改善SSI预防需要持续的教育和严格的监测策略.
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