Wenzel R P, Osterman C A, Hunting K J, Gwaltney J M
Am J Epidemiol. 1976 Mar;103(3):251-60. doi: 10.1093/oxfordjournals.aje.a112223.
A new system of surveillance is described for detecting hospital-aquired infections. Surveillance begins on the ward where a weekly review of the nursing care plan (Kardex) is used to select high risk patients (approximately 65% of the total population) for a subsequent chart review. A nurse-epidemiologist required 16-25 hr per week to perform surveillance and 4 more hr to organize line listings of infected patients. The Kardex review was 82 to 94 percent accurate in detecting nosocomial infections when compared to prospective reviews of the charts of all hospitalized patients. The new surveillance method was more accurate than a system based on weekly chart reviews of all patients receiving systemic antibiotics and/or of all patients with fever (temperature less than or equal to 37.8 C orally). In addition, it was more accurate and offered advantages over a system in which surveillance depended primarily on the bacteriology laboratory. Over a 12-month period 1154 hospital-acquired infections were identified for a 7% annual infection rate. Data from ongoing surveillance are used to record accurate infection rates by service, to define the risk of various hospital procedures, and to monitor for common source outbreaks of infection.
本文描述了一种用于检测医院获得性感染的新监测系统。监测从病房开始，每周对护理计划（ Kardex）进行审查，以选择高危患者（约占总人数的65%）进行后续病历审查。一名护士流行病学家每周需要16 - 25小时进行监测，另外还需要4小时来整理感染患者的一览表。与对所有住院患者病历的前瞻性审查相比，Kardex审查在检测医院感染方面的准确率为82%至94%。这种新的监测方法比基于对所有接受全身抗生素治疗的患者和/或所有发热（口腔温度小于或等于37.8摄氏度）患者进行每周病历审查的系统更准确。此外，它比主要依赖细菌学实验室的监测系统更准确且具有优势。在12个月的时间里，共发现1154例医院获得性感染，年感染率为7%。持续监测的数据用于按科室记录准确的感染率，确定各种医院操作的风险，并监测感染的共同来源爆发情况。
